A GIANT ANEURYSM OF PROPER HEPATIC ARTERY IN A CRYOGLOBULINEMIC PATIENT ON HEMODIALYSIS: A CASE REPORT.

Introductrion. Hepatic artery aneurysms (HAAs) are unusual vascular lesions often associated with many different pathological conditions. Most of reported cases are described in association with connective tissue diseases, such as polyarteritis nodosa and systemic lupus erythematosus. Case report. We observed a 52-year-old man with hypertension and HCV-related cryoglobulinemia complicated by end stage renal disease on replacement therapy by hemodialysis. He was admitted to our hospital because of the worsening of blood pressure values (170/110 mmHg) associated to new onset abdominal pain. After an initial physical examination, that showed a periumbelical bruit associated to a pulsatile mass…

Cecal trap: CT findings of isolated cecal necrosis

Learning objectives Background Findings and procedure details Conclusion Personal information References

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…

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

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

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

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…

Caustic ingestion: CT findings of esophageal injuries and thoracic complications

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

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

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

Palliative splenic irradiation in primary and post PV/ET myelofibrosis: outcomes and toxicity of three radiation schedules

Splenectomy and splenic irradiation (SI) are the sole treatment modalities to control drug resistant splenomegaly in patients with myelofibrosis (MF). SI has been used in poor surgical candidates but optimal total dose and fractionation are unclear. We retrospectively reviewed 14 MF patients with symptomatic splenomegaly. Patients received a median of 10 fractions in two weeks. Fraction size ranged from 0.2–1.4 Gy, and total dose varied from 2–10.8 Gy per RT course. Overall results indicate that 81.8% of radiation courses achieved a significant spleen reduction. Splenic pain relief and gastrointestinal symptoms reduction were obtained in 94% and 91% of courses, respectively. Severe cytopeni…

Renal endometriosis mimicking complicated cysts of kidney: report of two cases

Endometriosis is a common gynecologic disorder characterized by ectopic endometrial tissue growth outside the uterine cavity. Although usually occurring in pelvic organs, endometrial lesions may involve urinary tract. Renal endometriosis is extremely rare and it has only occasionally been reported in the past. We report two cases of patients with renal cystic lesions, incidentally found at imaging techniques during oncologic follow-up for gastric sarcoma and melanoma, initially misinterpreted as complicated haemorrhagic cysts and then histologically characterized as renal localizations of extragenital endometriosis.

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

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

Valutazione dei parametri volumetrici e funzionali cardiaci

IMPATTO DEL TEMA DELLA RADIOPROTEZIONE NELLA LETTERATURA RADIOLOGICA ITALIANA

Evaluate the interest aroused in the Italian radiological literature by radioprotection in the period 2004-2014, and its impact and development in national scientific research

Evaluation of lumbar pain with weight-bearing MRI: Preliminary experience.

Purpose Methods and Materials Results Conclusion References Personal Information

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

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

TRANS-CRANIAL MRI-GUIDED FOCUSED ULTRASOUND SURGERY (TCMRGFUS): PRELIMINARY ITALIAN (AND WORLD-FIRST) EXPERIENCE AT 1,5 TESLA (first 3 cases treated)

PURPOSE: We present our preliminary results achieved with the first Italian installation of a trans-cranial MRI-guided Focused Ultrasound Surgery (tcMRgFUS) certified system for functional neurosurgery. Moreover, to our knowledge, this is the world-first tcMRgFUS system ever installed on a 1.5T MRI unit. TcMRgFUS is a promising new technology for the non-invasive treatment of neurologic disorders such as Essential Tremor (ET), tremor dominant idiopathic Parkinson's Disease (PD) and Neuropathic Pain (NP). This is a new method for focal targeting and lesioning of specific regions in the brain through intact skull by using high intensity focused ultrasound beam to achieve thermal ablation and …

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

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

Role of LI-RADS Indeterminate Observations in the Risk of Hepatocellular Carcinoma after HCV Eradication with Direct-Acting Antivirals.

Purpose: To assess whether HCC (LR-5) occurrence may be associated with the presence of Liver Imaging Reporting and Data System (LI-RADS) indeterminate observations in patients with hepatitis C virus infection treated with direct acting antiviral (DAA) therapy. Materials and methods: This retrospective study included patients with HCV-related cirrhosis who achieved sustained virologic response (SVR) after DAA therapy between 2015 and 2019 and submitted to CT/MRI follow-ups with a minimum interval time of six months before and after DAA. Two blinded readers reviewed CT/MRI to categorize observations according to LI-RADS version 2018. Differences in rate of LI-RADS 5 observations (i.e., LR-5)…

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…

Concealed arrhythmogenic rigth ventricula cardiomyopathy: pathologic substrates and high resolution MRI

The attenuation of bronchodilatory effect of deep inspiration (DI) in COPD is related to reduced airway distensibility as measured by HRCT.

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…

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…

Densitometria TC nella diagnosi radiologica differenziale tra polmone senile ed enfisema nell’ anziano

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

Plantar fascia evaluation with a low-field MRI scanner in weight-bering position: our initial experience in patients with plantar fasciitis and in healthy volunteers

Purpose: To assess the usefulness of weight-bearing examination of the ankle performed with a low-field MRI scanner in the evaluation of plantar fascia in normal healthy volunteers and in patients with a clinical evidence of plantar fasciitis. Methods and Materials: We retrospectively evaluated ankle MR examinations in two groups of 40 patients each, performed between January and July 2008. Spin echo T1W, Gradient echo T2W, and Short Tau Inversion Recovery (STIR) images were acquired with a 0.2 T scanner (G-Scan, Esaote Biomedica, Genoa, Italy) in both weight-bearing position and normal conventional supine position. A dedicated extremities transmitter/receiver coil was used. The lesion site…

THE CLINICAL ACTIVITY SCORE IN MANAGEMENT OF GRAVES’ OPHTHALMOPATHY: CORRELATION WITH ORBITAL MR IMAGING.

Our aime was to investigate the correlation between GO ocular parameters obtained by MRI with contrast administration and the well-know clinical indicators of GO and to examine the relationship between the clinical course of hyperthyroidism and GO severity

Optimal local control and tolerability of three-dimensional conformal radiation therapy in prostate cancer: A single institutional experience of dose escalation in 125 patients

Aims To evaluate long-term late side effects, clinical and biochemical relapse in non-metastatic prostate cancer patients treated with dose escalation, from 74 to 78 Gy, by means of three dimensional conformal radiation therapy. Materials and Methods Clinical data of 125 patients with prostate cancer who underwent three-dimensional conformal radiation therapy were retrospectively evaluated. All patients were stratified, according to the NCCN classification, in low, intermediate and high risk, and all of them showed histologically proven adenocarcinoma stage T1–T3 with at least 2 years of follow-up. Late toxicity was analyzed using a modified Radiation Therapy Oncology Group toxicity scale. …

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

Tumor enhancement at contrast-enhanced CT and Gd-enhanced MRI for the assessment of treatment response of hepatocellular carcinoma (HCC) after sorafenib

Scopo: To investigate whether arterial enhancement of advanced HCC during pre-treatment and follow-up contrast-enhanced CT (CECT) or Gd-enhanced MRI (Gd-MRI) can be used to predict tumor response to sorafenib. Materiali e metodi: Seventeen patients (12M, 5F; mean age: 69 years) receiving sorafenib for inoperable HCC between 2007 and 2010 were included. Median interval time between pre-treatment and follow-up CECT or Gd-MRI was 160 days. Tumor arterial enhancement was measured at baseline and follow-up: (tumor attenuation/intensity on arterial phase – tumor attenuation/intensity on unenh! anced images)/(tumor attenuation/intensity on unenhanced images) x 100. Response was assessed according …

Congenitally corrected transposition of great vessels: MRI and echocardiographic appearance

This paper presents the case of a 36-year-old male with congenitally corrected transposition of great vessels (CTGV). This is a rare cardiac anomaly characterized by atrioventricular and ventriculoarterial discordance, occuriing in less than 1% of all congenital heart diseases. This was diagnosed by echocardiography and MRI. The MRI findings demonstrated cardiac abnormality.

Perfusion MRI in normal and abnormal pituitary gland. A preliminary study.

Perfusion MRI (magnetic resonance imaging) of the pituitary gland was performed in 20 healthy volunteers and 63 patients with various lesions involving the pituitary gland. All patients underwent sequential contrast-enhanced MRI using spoiled gradient recalled sequences with high temporal resolution (7 seconds). Four pituitary areas (pituitary stalk, posterior lobe, postero-superior, and antero-inferior adenohypophysis) were tested with a selected region of interest. Maximal contrast percentual variation was calculated. The timing of enhancement in normal patients matched perfectly with normal pituitary vascularization. Abnormal timing in pathological condition was investigated.

Conventional Radiology in the Evaluation of the Small Bowel

For many years, the small bowel has been considered as the “black box” of the gastrointestinal system because it could not be evaluated through endoscopy. For this reason, the conventional radiological methods, such as small bowel enteroclysis and small bowel follow-through, have been considered the standard approach for the evaluation of the small bowel in the diagnosis and management of Crohn’s disease for years. However, due to technological limits, the study of small bowel through conventional radiology has been focused mainly on its function than on its anatomy. To date, the conventional examination with the study of intestinal transit is now rarely used, if not obsolete, but it has st…

Può la misura della densità tumorale essere considerata un parametro attendibile nella valutazione della risposta ai trattamenti antiangiogenetici ed un fattore predittivo della PFS nell'HCC avanzato?

Different patterns of myocardial iron distribution by whole-heart T2* magnetic resonance as risk markers for heart complications in thalassemia major.

Background The multislice multiecho T2* cardiovascular magnetic resonance (CMR) technique allows to detect different patterns of myocardial iron overload (MIO). The aim of this cross-sectional study was to verify the association between cardiac complications (heart failure and arrhythmias), biventricular dysfunction and myocardial fibrosis with different patterns of MIO in thalassemia major (TM) patients. Methods We considered 812 TM patients enrolled in the Myocardial Iron Overload in Thalassemia (MIOT) Network. The T2* value in all the 16 cardiac segments was evaluated. Results We identified 4 groups of patients: 138 with homogeneous MIO (all segments with T2* < 20 ms), 97 with heterogene…

Preferential patterns of myocardial iron overload by multislice multiecho T2* CMR in thalassemia major patients.

T*(2) multislice multiecho cardiac MR allows quantification of the segmental distribution of myocardial iron overload. This study aimed to determine if there were preferential patterns of myocardial iron overload in thalassemia major. Five hundred twenty-three thalassemia major patients underwent cardiac MR. Three short-axis views of the left ventricle were acquired and analyzed using a 16-segment standardized model. The T*(2) value on each segment was calculated, as well as the global value. Four main circumferential regions (anterior, septal, inferior, and lateral) were defined. Significant segmental variability was found in the 229 patients with significant myocardial iron overload (glob…

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

Use of the directional atherectomy for the treatment of femoro-popliteal lesions in patients with critical lower limb ischemia

Femoro-popliteal PTA for the treatment of critical limb ischemia is frequently associated with unsatisfactory procedural success rates while directional atherectomy (DCA) has improved success rate since claudicant patients undergoing percutaneous treatment of femoro-popliteal obstructive disease. The aim of this prospective study is to evaluate the safety, efficacy and procedural success of DCA, at one year, in the percutaneous treatment of femoro-popliteal obstructive disease in patients with critical limb ischemia.Methods. From March 2012 to March 2013 18 consecutive patients with critical limb ischemia were treated with DCA (Turbohawk/ Covidien-ev3 Endovascular Inc., North Plymouth, Minn…

Is there still a role for lesioning in functional neurosurgery? Preliminary Italian (and world-first) experience with a trans-cranial MRI-guided focused ultrasound surgery system operating at 1.5 Tesla

ARRYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY: MULTISLICE COMPUTED TOMOGRAPHY FEATURES

Distribution and lower limit of normal of computed tomography (CT) density in non emphysematous senile lungs

Assessment of treatment response in hepatocellular carcinoma: a review of the literature

Hepatocellular carcinoma (HCC) has a high incidence all over the world. Even if the primary end point of treatment of HCC is survival, radiological response could be a surrogate end point of survival, and could have a key role in clinical management. Since 1950 several radiological response criteria have been applied; however, it was not until 2000 that specific criteria for HCC were introduced by the European Association for the Study of the Liver (EASL), and these were then standardized in 2010 with the development of the modified Response Evaluation Criteria for Solid Tumors (mRECIST) for HCC. The purpose of this brief review is to compare data in literature regarding the application an…

Classificazione ed imaging delle sindromi conflittuali della caviglia

Obiettivi didattici: Rivedere la classificazione ed illustrare i vari aspetti delle sindromi conflittuali alla radiografia convenzionale (RC), alla tomografia computerizzata multistrato (TCms), all'ecografia (US), alla risonanza magnetica (RM) ed all'artro-RM. Introduzione: Le sindromi conflittuali della caviglia dipendono da molte cause che possono essere distinte dal tipo di tessuto che determina il conflitto (osseo, fibroso, sinoviale).In generale, la classificazione delle sindromi conflittuali della caviglia prende in considerazione la sede anatomica relativa all'articolazione tibio-tarsica, e pertanto esse possono essere classificate in anteriore, antero-mediale, antero-laterale, poste…

Hepatocellular carcinoma in cirrhotic patients at multidetector CT: hepatic venous phase versus delayed phase for the detection of tumour washout.

OBJECTIVES: Our aim was to compare retrospectively hepatic venous and delayed phase images for the detection of tumour washout during multiphasic multidetector row CT (MDCT) of the liver in patients with hepatocellular carcinoma (HCC). METHODS: 30 cirrhotic patients underwent multiphasic MDCT in the 90 days before liver transplantation. MDCT was performed before contrast medium administration and during hepatic arterial hepatic venous and delayed phases, images were obtained at 12, 55 and 120 s after trigger threshold. Two radiologists qualitatively evaluated images for lesion attenuation. Tumour washout was evaluated subjectively and objectively. Tumour-to-liver contrast (TLC) was measured…

La termoablazione nel trattamento delle neoplasie epatiche primitive e secondarie

Radiofrequency thermoablation is a locoregional procedure based on the use of electromagnetic waves that induce movement and consequently the production of heat. This is the basis for the coagulative necrosis produced in the tissues. The method, experimented with and developed in the '90s, is today extensively used in the treatment of focal hepatic lesions, both primary and secondary. The factors that condition the procedure are related essentially to the characteristics of the tumours and to the possibility of obtaining a predictable area of necrosis that guarantees the radicality of the treatment. As regards primary neoplasms, it should be stressed that the treatment for hepatocellular ca…

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

CORONARY ARTERY BYPASS GRAFT (CABG) PATENCY: ASSESSMENT WITH 40-ROW MULTISLICE COMPUTED TOMOGRAPHY (MSCT) CERSUS CORONARY ANGIOGRAPHY

Rationale, design and methods of CTCA-PRORECAD (Computed Tomography Coronary Angiography Prognostic Registry for Coronary Artery Disease): a multicentre and multivendor registry.

PURPOSE: This study was done to assess the prognostic value of computed tomography coronary angiography (CTCA) in a large multicentre population of patients with suspected coronary artery disease (CAD) and, in particular, its incremental value compared with traditional methods for risk stratification. MATERIALS AND METHODS: This is a retrospective observational study that began in January 2003 conducted on patients with suspected CAD assessed with CTCA on the basis of symptoms (chest pain, dyspnoea) and/or abnormal or equivocal stress test and/or a high cardiovascular risk profile. The participating centres will provide data obtained with CTCA performed with 16-slice or higher equipment. Ex…

CT imaging findings of abdominopelvic vascular compression syndromes: what the radiologist needs to know.

AbstractAbdominopelvic vascular compression syndromes include a variety of uncommon conditions characterized by either extrinsic compression of blood vessels by adjacent anatomical structures (i.e., median arcuate ligament syndrome, nutcracker syndrome, May-Thurner syndrome) or compression of hollow viscera by adjacent vessels (i.e., superior mesenteric artery syndrome, ureteropelvic junction obstruction, ureteral vascular compression syndromes, portal biliopathy). These syndromes can be unexpectedly diagnosed even in asymptomatic patients and the predisposing anatomic conditions can be incidentally discovered on imaging examinations performed for other indications, or they can manifest wit…

Whole‐body magnetic resonance imaging (WB‐MRI) in lymphoma: State of the art

The improvements in magnetic resonance imaging (MRI) technology and the concern related to the increased cancer risk in patients with lymphoma, also due to radiation exposure associated with imaging examinations, have led to the introduction of whole-body MRI (WB-MRI) as a radiation-free alternative to standard imaging procedures. WB-MRI seems a less histology-dependent functional imaging test than 18 F-fluorodeoxyglucose-positron emission tomography/CT (18 F-FDG-PET/CT). In patients with FDG-avid lymphomas, such as diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (HL), 18 F-FDG-PET/CT remains the imaging reference standard for staging, with WB-MRI potentially being a complementar…

Radiographic and chest CT imaging presentation and follow-up of COVID-19 pneumonia: a multicenter experience from an endemic area.

COVID-19 has infected more than 2 million people in the world in less than 5 months outbreak. Chest imaging is recommended for triage of suspected cases of COVID-19 with moderate-severe clinical features and high pre-test probability of disease, and may help for patient follow-up and to identify patients at higher risk of disease worsening. This pictorial essay illustrates typical and uncommon imaging findings of COVID-19 pneumonia and the role of imaging for patient management.

Il menisco “galleggiante”: importante segno RM di distacco meniscale dal piatto tibiale. Implicazioni chirurgiche.

OBIETTIVO: In questo lavoro descriviamo un segno poco noto, detto menisco “galleggiante”, cioè menisco circondato da fluido, per rottura o distrazione dei legamenti coronari. E’ importante identificare tale reperto, in quanto un menisco “galleggiante” andrebbe operato e riattaccato il prima possibile, al fine di evitare possibili complicanze. MATERIALE E METODI: Abbiamo analizzato in maniera retrospettiva 2500 esami di ginocchio nel periodo compreso tra Gennaio 2006 e Marzo 2007. Tutti gli esami sono stati eseguiti su un magnete da 1,5 T (Signa Excite, GE Healthcare) o su un magnete da 0,2 T (Arto-Scan C, Esaote). Come criterio diagnostico è stato usato uno spessore maggiore di 3 mm del seg…

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

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

CT densitometry-based differential diagnosis between emphysematous and non-emphysematous lungs in elderly patients.

Purpose Methods and Materials Results Conclusion References Personal Information

Small solid renal masses: Characterization by diffusion-weighted MRI at 3 T

AIM: To describe the appearance of small solid renal lesions (≤3 cm) on diffusion-weighted magnetic resonance imaging (MRI) and to determine whether ADC measurements may help to differentiate benign from malignant small solid renal masses. METHODS AND MATERIALS: Thirty-five patients with 47 small renal masses (23 malignant, 24 benign) who underwent 3 T MRI of the kidney using diffusion-weighted sequences (b values of 0 and 1000 s/mm(2)) were retrospectively evaluated. Qualitative and quantitative analysis of diffusion-weighted images was performed. RESULTS: Most lesions were hyperintense to kidney on high b-value diffusion-weighted images and hypointense on apparent diffusion coefficient (A…

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

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

Patologia congenita

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

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

Ruolo dell' HRCT nello studio del rimodellamento delle pareti delle vie aeree nell' asma.

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

MR-imaging features of hepatocellular carcinoma capsule appearance in cirrhotic liver: comparison of gadoxetic acid and gadobenate dimeglumine.

Purpose: The purpose of the study is to compare the MR-imaging features of hepatocellular carcinoma (HCC) capsule appearance on gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging, using imaging-based presumptive diagnosis of HCC as the reference standard. Methods: Gadoxetic acid and gadobenate dimeglumine-enhanced MR imaging of 51 patients with 71 HCCs were retrospectively reviewed. Three readers graded in consensus, using a five-point scale, the presence (score 4–5) of capsule appearance on images obtained during T1-weighted GRE portal venous phase (PVP), 3-min phase, and hepatobiliary phase (HBP). The Fisher's exact test and the t student unpaired test were performed. Results: …

T2 Mapping of the Sacroiliac Joints in Patients with Axial Spondyloarthritis

Purpose: To test whether T2 mapping of the sacro-iliac joints (SIJs) might help identifying patients with spondyloarthritis. Method: This study included 20 biologic-naive patients with axial spondyloarthritis (10 females; mean age: 38 ± 9years; range, 19–47) and 27 controls (16 males; mean age = 39 ± 13years; range = 28–71) who prospectively underwent SIJs MRI at 1.5 T, including a multislice multiecho spin-echo sequence. Standard MRIs were reviewed to assess the SIJs according to the Assessment of SpondyloArthritis International Society (ASAS) criteria and SPondyloArthritis Research Consortium of Canada (SPARCC) MRI index. T2 maps obtained from multiecho sequences were used to draw regions…

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

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.

Abdominal splenosis and its differential diagnoses: What the radiologist needs to know

Abstract Splenosis is a benign acquired condition characterized by the presence of heterotopic viable splenic tissue in other organs or within cavities such as peritoneum, retroperitoneum, or thorax after splenic trauma or surgery. Abdominal splenosis is often an incidental finding and computed tomography and magnetic resonance usually allow a confident diagnosis. The typical enhancement that parallels the spleen is a useful hallmark of splenosis. Splenic implants lack contrast uptake in the hepatobiliary phase and show high signal at high b-values on diffusion-weighted images. In some cases splenosis may mimic malignant and benign conditions in the peritoneum as well as in hollow and paren…

APPROCCIO NON INVASIVO PER LO STUDIO DEL CIRCOLO CORONARICO CON TC MULTISLICE

DEEP VEIN THROMBOSIS IN A LEFT-PLACED INFERIOR VENA CAVA

UTILITA’ DELLA ANGIOGRAFIA CORONARICA ESEGUITA MEDIANTE TOMOGRAFIA COMPUTERIZZATA MULTIDETETTORE NEL CONTROLLO DELLA PERVIETA’ DEL BYPASS AORTO-CORONARICO

Whole-body diffusion-weighted MR and FDG-PET/CT in Hodgkin Lymphoma: Predictive role before treatment and early assessment after two courses of ABVD

Abstract Purpose To evaluate whether imaging features of pathologic lymph nodes on whole-body diffusion-weighted MR have a predictive role before treatment and may assess the response after two courses of chemotherapy in comparison to FDG-PET/CT in Hodgkin Lymphoma. Materials and methods We reviewed the whole-body MR and FDG-PET/CT performed on 41 patients with Hodgkin Lymphoma before and after two Doxorubicin-Bleomycin-Vinblastine-Dacarbazine (ABVD). Responder and non-responder lesions were identified on interim-FDG-PET/CT performed after two ABVD. We used Multivariate Generalized Estimating Equations model to assess statistical association between being-responder and baseline-Maximum Stan…

Feasibility, reproducibility, and reliability for the T*2 iron evaluation at 3 T in comparison with 1.5 T

This study aimed to determine the feasibility, reproducibility, and reliability of the multiecho T * 2 Magnetic resonance imaging technique at 3 T for myocardial and liver iron burden quantification and the relationship between T * 2 values at 3 and 1.5 T. Thirty-eight transfusion-dependent patients and 20 healthy subjects were studied. Cardiac segmental and global T * 2 values were calculated after developing a correction map to compensate the artifactual T * 2 variations. The hepatic T * 2 value was determined over a region of interest. The intraoperator and interoperator reproducibility for T * 2 measurements at 3 T was good. A linear relationship was found between patients' R (1000/T * …

Correlazioni tra rilievi HRCT e test funzionali nella interstiziopatia polmonare sclerodermica

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

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

Carotid intima media thickness and coronary atherosclerosis linkage in symptomatic intermediate risk patients evaluated by coronary computed tomography angiography.

Background: There is a growing evidence that carotid intima media thickness (CIMT) is associated with coronary artery disease (CAD) and it should be used as a predictor of atherosclerotic burden of coronary arteries. However, these studies have been performed by using invasive coronary angiography (ICA) and in high-risk patients for CAD. The purpose of this study was to evaluate the correlation between CIMT by ultrasound and coronary atherosclerosis in symptomatic intermediate risk patients by coronary computed tomography angiography (CCTA). Methods: We enrolled 204 consecutive symptomatic patients (mean age: 61 +/- 10; men: 118) and intermediate risk for CAD. All patients underwent CIMT ul…

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…

Use of saline chaser in the intravenous administration of contrast material non invasive coronary angiography with 16 row multislice CT

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

Benign and malignant conditions in hepatic capsular retraction

Cardioradiologia

Whole-body MRI, FDG-PET/CT, and bone marrow biopsy, for the assessment of bone marrow involvement in patients with newly diagnosed lymphoma.

To compare whole-body MRI (WB-MRI) with diffusion-weighted imaging (DWI), FDG-PET/CT, and bone marrow biopsy (BMB), for the evaluation of bone marrow involvement (BMI) in patients with newly diagnosed lymphoma.This retrospective study was approved by our Institutional Review Board. Two independent radiologists and one nuclear medicine specialist reviewed all WB-MRI and FDG-PET/CT scans prospectively performed on 104 patients with newly diagnosed lymphoma (53 males; 47 Hodgkin; mean age: 44 years; range, 15-86 years) between 2013 and 2015. The delay between imaging scans and BMBs was up to 10 days. The diagnostic accuracy of WB-MRI (1.5 Tesla MR scanner, with T1w, T2w-STIR, and DWI sequences…

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

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.…

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

Non-invasive diagnosis in a case of bronchopulmonary sequestration and proposal of diagnostic algorhythm

The case of a 43-year-old woman with intralobar pulmonary sequestration, Pryce type one, is presented. The medical history was characterised by recurrent bronchopneumonia, productive cough with purulent sputum and hemoptysis in the last three years. Diagnosis was made by CT angiography: multiplanar, maximum intensity projection and volume rendering reconstructions were visualised. A volume reduction of middle and lower lobe with multiple cyst-like bronchiectasis was detected and no evident relationship with tracheobronchial tree was pointed out. Reconstructions aimed at evaluating bronchial structures demonstrated no patency of middle and lower lobar bronchi. The study carried out after con…

Sonografic examination of epiaortic vessels in patients with peripheral vertigo

Abstract Introduction: To evaluate the utility of echo-color-Doppler ultrasonography (CDU) of extracranial brain-supplying vessels in patients with peripheral vertigo of unknown origin. Materials and methods: One-hundred-fifty-six patients (study group; 42 male and 114 female; mean age 61.86 14.14) and 161 patients (control group; 80 male and 81 female; mean age 62.31 13.69) were prospectively evaluated with CDU of extracranial brain-supplying vessels. Plaques in common and/or internal carotid artery (CA), arterial wall intima-media thickness (IMT) of common CA and peak systolic velocity (PSV) and resistive index (RI) of vertebral arteries (VA) were evaluated. Parametric (t-test) and non-pa…

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&lt;0.05); no injury has been reporte…

L'ESSENZIALE NELL'IMAGING RM DI DIFFUSIONE, COLLO

Cavernous haemangioma associated with other hepatic masses at CT and MRI

Cavernous haemangioma associated with other hepatic masses at CT and MRI Nome del convegno: ESGAR 2004 Dettaglio tipologia d'Ateneo: 9 - Abstract di Comunicazioni o Poster di Congressi internazionali pubblicati (anche on line)

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

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

Multicenter validation of the magnetic resonance t2* technique for segmental and global quantification of myocardial iron

Purpose To assess the transferability of the magnetic resonance imaging (MRI) multislice multiecho T2* technique for global and segmental measurement of iron overload in thalassemia patients. Materials and Methods Multiecho T2* sequences were installed on six MRI scanners. Five healthy subjects (n = 30) were scanned at each site; five thalassemia major (TM) patients were scanned at the reference site and were rescanned locally (n = 25) within 1 month. T2* images were analyzed using previously validated software. Results T2* values of healthy subjects showed intersite homogeneity. On TM patients, for global heart T2* values the correlation coefficient was 0.97, coefficients of variation (CoV…

LE SEQUENZE T2-FLAIR E DWI NELLA DIAGNOSI DI ENCEFALOPATIA DI WERNICKE NON ALCOOL- CORRELATA

SCOPO DEL LAVORO Valutare l’accuratezza delle immagini T2-FLAIR e DWI nello studio delle lesioni caratteristiche dell’Encefalopatia di Wernicke. MATERIALI E METODI Studio effettuato su donna di 56 anni, affetta da Encefalopatia di Wernicke non alcool-correlata. Nel Dicembre 2011 la paziente è stata sottoposta ad esame RM, utilizzando un tomografo operante a 1,5 T con acquisizione di scansioni sui piani assiale, sagittale e coronale in tecnica Spin-Echo (SE), Fast Spin-Echo (FSE), Fluid Attenuated Inversion Recovery (FLAIR) e Diffusion Weighted Imaging (DWI), con sequenze T1 e T2 pesate. L’esame è stato completato dopo infusione e.v. di m.d.c. paramagnetico. L’indagine mostrava la presenza…

Il Tecnezio: storia, usi e applicazioni.

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

79. Amyloid-PET analysis based on tissue probability maps

Purpose The regional quantification of amyloid burden is crucial for the clinical diagnosis of Alzheimer’s disease [1]. The best method to evaluate regional amyloid deposition in PET is through the use MR imaging for brain space normalization. However, since MR imaging is not always available in the clinical practice, a MR-less methodology is needed in order to compute semi-quantitative and analyze regional amyloid burden. Methods Forty-four patients with clinical evidence of dementia, underwent 18F-Florbetaben PET (FBB-PET), FDG-PET, neuropsychological assessment and cerebrospinal fluid analysis. We implemented a methodology that uses SPM12 to import and normalize the FBB-PET images in Mon…

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

Aorta addominale e vasi splancnici

PI-RADS 3 Lesions: Role of Prostate MRI Texture Analysis in the Identification of Prostate Cancer

Abstract Purpose To determine the diagnostic performance of texture analysis of prostate MRI for the diagnosis of prostate cancer among Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions. Materials and Methods Forty-three patients with at least 1 PI-RADS 3 lesion on prostate MRI performed between June 2016 and January 2019 were retrospectively included. Reference standard was pathological analysis of radical prostatectomy specimens or MRI-targeted biopsies. Texture analysis extraction of target lesions was performed on axial T2-weighted images and apparent diffusion coefficient (ADC) maps using a radiomic software. Lesions were categorized as prostate cancer (Gleason score [GS] …

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…

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…

Diagnostic wor-up of arrhythmogenic right ventricular cardiomyopathy with MR

PIELONEFRITI: IL RUOLO DEL RADIOLOGO AD UNA DIAGNOSI COMPLESSA

BRONCHIAL ARTERY EMBOLIZATION IN CYSTIC FIBROSIS PATIENTS: A SINGLE CENTRE EXPERIENCE

Resting state FMRI: A tool to investigate functional connectivity modulation induced by transcranial direct current stimulation of the motor network

Introduction: Resting-state functional connectivity (fcMRI) represents a novel fMRI approach that allows detection of temporal correlations in spontaneous BOLD signal oscillations while subjects rest quietly in the scanner. Under resting conditions the brain is engaged in spontaneous activity that causes a low frequencies (<0.1 Hz) BOLD signal fluctuations. Functional connectivity (FC) can be defined as the synchrony of neural activity among spatially distant regions. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that is known to modulate cortical activity and FC among brain regions, as measured by functional magnetic resonance imaging. This st…

Radiological Follow-Up of Inflammatory Bowel Diseases

Inflammatory bowel diseases (IBD) are chronic gastrointestinal diseases that typically affect the young working-age population. Patients with IBD, both asymptomatic and symptomatic, often develop complications during their clinical course. This is particularly true in patients with Crohn’s disease (CD) and biological signs of inflammation, despite being asymptomatic. In addition, it seems clear that the absence of symptoms does not imply an absence of inflammation. For all the above mentioned reasons, patients should be followed up and objectively evaluated. IBD are idiopathic diseases characterized by periods of remission and frequent exacerbations. To appreciate the impact of disease pr…

Valutazione della risposta bronchiale ai respiri profondi mediante HRCT nell’asma e nella BPCO

Imaging delle coalizioni tarsali

anomalie congenite , tarso , imaging

Caso 37 Patologia Aortica

Clinical case

Semi-automated evaluation of small bowel mural attenuation at CT enterography using different temporal windows in patients affected by active Crohn disease

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

Diagnostic accuracy of multislice computed tomography coronary angiography is improved at low heart rates

Utilizzo di TAC multistrato con tecnica spirale nella ricostruzione dei tramiti intracranici da colpi d'arma da fuoco

Imaging features of solid renal masses

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

HRCT evaluation of bronchial response to deep inspiration in asthma and chronic obstructive pulmonary disease (COPD)

Purpose Methods and Materials Results Conclusion References Personal Information

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

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

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

Correlazione tra tubercolo laterale del calcagno e tendinopatia dei peronei ruolo della rm .

Is there still a role for lesioning in functional neurosurgery: the Italian experience of delivering focused ultrasound high energy through a 1,5 tesla MR apparatus.

CT and CT angiography scan technique.

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

Tomografia computerizzata e risonanza magnetica

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…

Radiological Features of Gastrointestinal Lymphoma.

Gastrointestinal lymphomas represent 5–20% of extranodal lymphomas and mainly occur in the stomach and small intestine. Clinical findings are not specific, thus often determining a delay in the diagnosis. Imaging features at conventional and cross-sectional imaging must be known by the radiologist since he/she plays a pivotal role in the diagnosis and disease assessment, thus assisting in the choice of the optimal treatment to patients. This review focuses on the wide variety of imaging presentation of esophageal, gastric, and small and large bowel lymphoma presenting their main imaging appearances at conventional and cross-sectional imaging, mainly focusing on computed tomography and magne…

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…

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

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

Advanced techniques in Magnetic Resonance Imaging: characterization of non-gaussian water diffusion using DIFFUSION KURTOSIS IMAGING (DKI)

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 …

SEMEIOTICA NEURORADIOLOGICA E POSSIBILI DIAGNOSI DIFFERENZIALI DI UN RARO CASO DI MIELOLIPOMA PRESACRALE

SCOPO Presentiamo il caso di una paziente anziana (74aa) con tipica sintomatologia da artrosi e discopatia lombo-sacrale (rigidità e dolore alla regione lombare con tipica irradiazione ai glutei ed alla superficie posteriore di entrambi gli arti inferiori, con associata sensazione di intorpidimento) e segni di radicolopatia L4-L5-S1 all’esame obiettivo neurologico, che si presenta alla nostra attenzione per eseguire un esame RM del rachide lombo-sacrale. MATERIALI E METODI L’esame RM è stato eseguito in condizioni di base con sequenze TSE-T1, TSE-T2 e STIR-T2 secondo piani sagittali ed assiali (GE Signa HDxt 1,5T). E’ stata inoltre effettuata un’integrazione RM dopo somministrazione di md…

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

Diffusion Kurtosis Imaging: prime applicazioni cliniche in ambito neuroradiologico

Nutcracker syndrome due to left renal vein compression by an aberrant right renal artery

Classic nutcracker syndrome is caused by left renal vein compression between the superior mesenteric artery and aorta, leading to retrograde venous hypertension associated with such urinary abnormalities as hematuria or proteinuria. We describe a case of symptomatic nutcracker syndrome treated by means of stent placement in which hypertension in the left renal vein was caused by stenosis of this vein compressed by an aberrant right renal artery at a point closer to the inferior vena cava.

Efficacy of raw implementation and reduction dose protocols in CT colonoscopy: a single centre 4 years retrospective review

Aims and objectives Methods and materials Results Conclusion Personal information References

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

A CASE OF A PRESACRAL MYELOLIPOMA: IMAGING FINDINGS AND DIFFERENTIAL DIAGNOSIS CHECKLIST OF OTHER PRESACRAL MASSES

PURPOSE: There have been many reports describing adrenal myelolipoma but there have been only few reports of extraadrenal myelolipoma. We describe a case of an elderly woman with lower back pain due to age-related spondyloarthrosis and mild discopathy with a presacral myelolipoma as incidental finding. We also discuss about common and uncommon imaging findings of other presacral masses. METHODS: A 74 years-old woman came to our observation to perform an MRI of the lumbar spine for typical lumbar back pain. MR imaging revealed, in addition to the signs of mild scoliosis and spondylo-disc-arthrosis, a presacral mass showing heterogeneously high signal in all sequences and almost completely su…

Osteonecrosis in Hodgkin lymphoma treated by BEACOPP

Approaches and techniques for imaging guided for needle placement in MR Arthrography of the shoulder

Cumulative radiation CT dose in young traumatic patients: a single centre 5 years retrospective review

Functional connectivity modulation induced by transcranial direct current stimulation of the motor network investigated by resting state fMRI

This study is aimed at measuring the variation of functional connectivity between cortical brain regions after tDCS along time. For this purpose we enrolled 20 healthy right-handed subjects.

Characterization of focal liver lesions

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

Response Assessment to Cancer Therapy

Cancer generically refers to a group of diseases showing an uncontrolled division of abnormal cells potentially having the ability to invade, through the blood and lymph systems, nearby tissues or spread to other parts of the body.

Hepatocellular carcinoma (HCC) with indeterminate findings at initial CT or MRI: Does imaging follow-up allow detection of conclusive imaging findings before significant tumor growth?

Hamartoma of the urinary bladder: case report and review of the literature.

Bladder hamartoma is a rare benign entity with only eight cases reported in the literature thus far, and whose general imaging features have not, to our knowledge, been previously discussed. The purpose of this report is to review the literature and to discuss the imaging findings in one case of bladder hamartoma where US features were those of an inhomogeneous solid mass with an unechogenic center, which was in accordance with the CT findings of a soft tissue mass with central inhomogeneous enhancement due to central necrosis.

Valutazione radiografica mirata dello spazio articolare femoro-tibiale in pazienti affetti da patologia artrosica ed artritica

OBIETTIVO: Scopo del nostro lavoro è quello di valutare lo spazio articolare dell’articolazione del ginocchio utilizzando una proiezione specifica con paziente in decubito ortostatico. MATERIALE E METODI: Dal Settembre 2006 al Febbraio 2007 sono stati valutati 30 pazienti (18 M/ 12 F; età media 56 anni) per patologia artrosica o artritica del ginocchio. Come gruppo di controllo sono stati utilizzati 10 pazienti con pregresso trauma del ginocchio. In tutti i pazienti è stato acquisito un radiogramma del ginocchio con tecnica convenzionale ed un radiogramma con tecnica mirata allo valutazione dello spazio articolare (posizione ortostatica con ginocchia leggermente flesse, proiezione PA e fasc…

Magnetic resonance findings in scuba diving-related spinal cord decompression sickness

Scuba diving is associated with risk of severe decompression sickness (DCS type II), which results from rapid reduction of the environmental pressure sufficient to cause the formation into tissue or blood of inert gas bubbles previously loaded within tissues as a soluble phase. DCS type II constitutes a unique subset of ischemic insults to the central nervous system (CNS) with primarily involvement of the spinal cord. Ten patients with diving-related barotrauma underwent neurologic examination. Two of them presented progressive sensory and motor loss in the extremities at admission and were presumed affected by spinal cord DCS. Magnetic resonance imaging (MRI) demonstrated abnormalities in …

Can 3D Digital Breast Tomosynthesis (DBT) improve breast malignant pathology detection? A case-to-case imaging comparison between 3D DBT and 2D Mammographic images

Learning objectives Background Findings and procedure details Conclusion Personal information References

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.

Liver disease severity and low bone mineral density in HIV mono-infected and HIV/HCV co-infected patients

Background: In this study we assess: prevalence of osteopenia, osteoporosis and reduced bone mineral density in HIV infection and HIV / HCV co-infection;risk factors associated with reduced bone mineral density(BMD); relationship between bone mineral density and reduced liver fibrosis (FE) measured as "liver stiffness" (LS), by FibroScan ® in patients co-infected with HIV / HCV; relationship between reduced bone mineral density and cardiovascular risk assessed with the 10-year Framingham risk score (FRS) in HIV / HCV co-infected Patients And Methods: One hundred and ninety-four HIV-infected subjects (121 males =62% and 73 females = 38 %): 129 HIV-infected ( 66.5 % ) and 65 HIV / HCV co-infe…

Utilizzo di TAC multistrato nella ricostruzione dei tramiti intracranici da colpi d'arma da fuoco

virtopsy

Multiple sclerosis: High prevalence of the ‘central vein’ sign in white matter lesions on susceptibility-weighted images

Purpose The aim of this study was to determine the occurrence and distribution of the ‘central vein’ sign in white matter lesions on susceptibility-weighted magnetic resonance images in patients with multiple sclerosis (MS) and cerebral small vessel disease (CSVD). Materials and methods T2-weighted and fluid-attenuated inversion recovery magnetic resonance images of 19 MS patients and 19 patients affected by CSVD were analysed for the presence and localisation of focal hyperintense white matter lesions. Lesions were subdivided into periventricular or non-periventricular (juxtacortical, subcortical, deep white matter and cerebellar) distributed. The number and localisation of lesions present…

TOMOGRAFIA COMPUTERIZZATA MULTISTRATO E VALUTAZIONE CORONARICA NON INVASIVA

Imaging RM nella Sindrome da impingement del muscolo quadrato del femore .

Whole-body MRI, FDG-PET/CT, and bone marrow biopsy, for the assessment of bone marrow involvement in patients with newly diagnosed lymphoma

Purpose To compare whole-body MRI (WB-MRI) with diffusion-weighted imaging (DWI), FDG-PET/CT, and bone marrow biopsy (BMB), for the evaluation of bone marrow involvement (BMI) in patients with newly diagnosed lymphoma. Materials and Methods This retrospective study was approved by our Institutional Review Board. Two independent radiologists and one nuclear medicine specialist reviewed all WB-MRI and FDG-PET/CT scans prospectively performed on 104 patients with newly diagnosed lymphoma (53 males; 47 Hodgkin; mean age: 44 years; range, 15–86 years) between 2013 and 2015. The delay between imaging scans and BMBs was up to 10 days. The diagnostic accuracy of WB-MRI (1.5 Tesla MR scanner, with T…

Bladder tumor staging: comparison of contrast-enhanced and gray-scale ultrasound

OBJECTIVE. The purpose of this study was to evaluate the effectiveness of contrast-enhanced sonography in comparison with conventional sonography in differentiating muscle- infiltrating and superficial neoplasms of the urinary bladder. SUBJECTS AND METHODS. Conventional and contrast-enhanced sonography were performed on 34 consecutively registered patients with bladder tumors. All examinations were reviewed by two independent sonologists. At gray-scale sonography, interruption of the hyperechoic bladder wall was considered the main diagnostic criterion for differentiating superficial and infiltrating tumors. At contrast-enhanced sonography, a tumor was considered superficial when the hypoen…

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…

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

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

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

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

The Attenuation of the Bronchodilatory Effect of Deep Inspiration (DI) in COPD Is Related to Reduced Airway Distensibility as Measured by HRCT

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".

Associated Factors and Liver Disease Severity for Decreased Bone Mineral Density in HIV Mono- and HIV/HCV Co-infected Patients

Objective: We assessed the prevalence and risk factors of decreased bone mineral density (BMD) in patients mono-infected with human immunodeficiency virus (HIV) or co-infected with hepatitis C virus (HIV/HCV). We also evaluated whether bone loss was linked to lipid asset in both groups and to severity of liver fibrosis in the co-infected group. Methods: We consecutively enrolled 194 HIV-patients (129 mono-infected and 65 co-infected). All HIV-patients underwent dual-energy X-ray absorptiometry (DXA), while co-infected patients underwent transient elastography. Advanced liver fibrosis was defined as a median liver stiffness ≥ 9.5 kPa. Fibrosis was also assessed in all the HIV-patients using …

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…

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

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

The color Doppler with contrast agent US in the study of post cholecistectomy syndrome

Purpose. This paper describes the role of MR imaging in the identification of the different macroscopic patterns of lipoma arborescens. Materials and Methods. Between June 1995 and January 2004, a total of 6387 MR examinations of the knee were retrospectively assessed for the presence of lipoma arborescens. The MR examinations were performed using a superconductive 0.5 T MR unit with a transmitting/receiving coil dedicated for the extremities, The MR images were acquired with SE T1-weighted, GE T2*-weighted and STIR sequences in sagittal, coronal and axial planes with 3-mm thickness and 1-mm gap. Results. Lipoma arborescens was identified in 9 patients (mean age: 36 years). In 2/9 cases a l…

MALATTIA DI ERDHEIM–CHESTER: RARE LOCALIZZAZIONI SPLANCNO- ED INTRA-CRANICHE IN PAZIENTE CON STADIO AVANZATO DI MALATTIA

SCOPO DEL LAVORO Presentiamo il caso di una donna di 63 anni con storia di pseudotumor orbitae e diagnosi tardiva di Malattia di Erdheim-Chester (MEC) con coinvolgimento multisistemico e rare localizzazioni a livello splancno- ed intracranico. MATERIALI E METODI La paziente, a causa della comparsa di astenia progressivamente ingravescente, vomito e disfagia per i solidi veniva condotta al PS dove eseguiva ECG ed esami ematochimici e veniva ricoverata con la diagnosi di disidratazione e squilibrio elettrolitico. L’esame obiettivo evidenziava pallore e disidratazione di cute e mucose, ipotrofia muscolare e proptosi bulbare bilaterale da pseudotumor orbitario infiammatorio cronico con evidenti…

Pitfalls on Postmortem Imaging: The Need of Blending Conventional and Virtual Autopsy on Burnt-Charred Body

Joining forensic traditional autopsy and CT-MR postmortem virtual approach may assist forensic experts in adequate reconstruction of cause, manner, and way of death, significantly to find evidence of found wound/fracture and relative interpretation. Evaluation of criminal burning is often a difficult challenge in the view of misinterpretation of wound/fracture victims and usually poor case history of this criminal offense. In this scenario, a strong collaboration between imaging and classical forensic techniques is helpful.

Postmortem Imaging in Sudden Adult Death

Several definitions of “sudden and unexpected death” exist. The World Health Organization definition is of natural death within 24 h from the onset of symptoms, but this is much too long for many clinicians and pathologists; some will only accept death within 1 h from the onset of illness. If the event was not witnessed, sudden death is defined as the interval between the time the subject was last seen and the time the body was found within 6 h.

Relationship between anxiety level and radiological investigation. Comparison among different diagnostic imaging exams in a prospective single-center study

Objective: Every patient could feel anxious when he waits in a radiological department to undergo diagnostic exams. The aim of our study is to evaluate the impact of the radiological exams on patient anxiety. Materials and methods: We evaluated 343 patients (mean age 54.83 years) who underwent different types of diagnostic exams in the Department of Diagnostic Imaging at our Hospital from April 2013 to August 2014. We administered to patients the State and Trait Anxiety Inventory Test, which detected with high sensitivity both state anxiety and trait anxiety. A team of clinical psychologists and radiologists evaluated the scores obtained. Results: 83 out of 343 patients were excluded becaus…

Combining split-and-merge and multi-seed region growing algorithms for uterine fibroid segmentation in MRgFUS treatments

Uterine fibroids are benign tumors that can affect female patients during reproductive years. Magnetic resonance-guided focused ultrasound (MRgFUS) represents a noninvasive approach that uses thermal ablation principles to treat symptomatic fibroids. During traditional treatment planning, uterus, fibroids, and surrounding organs at risk must be manually marked on MR images by an operator. After treatment, an operator must segment, again manually, treated areas to evaluate the non-perfused volume (NPV) inside the fibroids. Both pre- and post-treatment procedures are time-consuming and operator-dependent. This paper presents a novel method, based on an advanced direct region detection model, …

Forensic study of Neolithic and Punic skulls with MSCT

Learning objectives Background Imaging findings OR Procedure details Conclusion References Personal Information

Correlation between ferrous ammonium sulfate concentration, sensitivity and stability of Fricke gel dosimeters exposed to clinical X-ray beams

Abstract This work describes the characterization of various Fricke-Agarose-Xylenol gels (FXG) dosimeters using NMR relaxometry and MRI analysis. Using X-rays from a clinical linear accelerator (LINAC), the gels were irradiated in the dose range from 0 Gy to 20 Gy. The photon sensitivity of the FXGs was measured in terms of NMR relaxation rates; its dependence on radiation dose was determined as a function of ferrous ammonium sulfate contents (from 0.5 mM to 5 mM). Furthermore, the stability of the NMR signal was monitored over several days after irradiation. These measurements were aided by Magnetic Resonance Imaging (MRI) scans which allowed three-dimensional (3D) dose mapping. In order t…

Il trattamento infiltrativo eco-guidato nella rizoartrosi: risultati

The "serpent sign" in hydatid disease.

Intrabiliary rupture of hepatic hydatid cyst: MRI findings

Learning objectives Background Findings and procedure details Conclusion Personal information References

3D TC role in cranic trauma autopsies. A case report

The case aims to show radiological essays could be useful to forensic investigations even if they can not substitute autopsy

Choline PET/CT Features to Predict Survival Outcome in High Risk Prostate Cancer Restaging: A Preliminary Machine-Learning Radiomics Study

Background Radiomic features are increasingly utilized to evaluate tumor heterogeneity in PET imaging but to date its role has not been investigated for Cho-PET in prostate cancer. The potential application of radiomics features analysis using a machine-learning radiomics algorithm was evaluated to select 18F-Cho PET/CT imaging features to predict disease progression in PCa. Methods We retrospectively analyzed high-risk PCa patients who underwent restaging 18F-Cho PET/CT from November 2013 to May 2018. 18F-Cho PET/CT studies and related structures containing volumetric segmentations were imported in the "CGITA" toolbox to extract imaging features from each lesion. A Machine-learning model h…

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…

PERFORMANCE OF DIFFUSION KURTOSIS IMAGING FOR CHARACTERIZATION OF PROSTATE LESIONS USING 1.5T MAGNETIC RESONANCE IMAGING SCANNER

The aim of the study is to evaluate the diagnostic performance of apparent diffusion coefficient (ADC) and apparent kurtosis coefficient (Kapp) for the characterization of prostate lesions on 1.5T MRI. This retrospective study included 34 patients with at least one lesion with PI-RADS score≥ 3. Performances of ADC and Kapp were evaluated using the Mann-Whitney U test and receiver operating characteristics curve (AUROC). Lesions with Gleason score≥6 had significantly lower Kapp compared to benign lesions (p=0.025). The ADC-ratio was the only significantly different parameter between GS≥7 and GS=6 lesions (p=0.039). Kapp showed the largest AUROC for the diagnosis of GS≥6 prostate cancers (AUR…

Encefalopatia ipertensiva cronica (EIC): sensibilità delle sequenze GE-T2* a confronto con le SWI nell'identificazione dei micro-sanguinamenti

L'EIC è caratterizzata dalla presenza di lesioni parenchimali irreversibili, risultato di una lunga esposizione a regimi pressori patologici specie in pazienti che non seguono o non rispondono alle comuni terapie mediche. Si riscontrano quali reperti tipici multipli esiti gliotici, leucoaraiosi e multiple lesioni lacunari con predilezione per le localizzazioni profonde ai nuclei lenticolari, ai talami e al ponte. Più raramente possono evidenziarsi minuti foci emorragici parenchimali, più frequentemente localizzati nei gangli della base ma anche nel ponte e nel cervelletto, che in alcuni casi possono rappresentare la manifestazione principale della patologia: questi microsanguinamenti, vi…

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…

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…

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…

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…

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…

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.

Whole body magnetic resonance in indolent lymphomas under watchful waiting: The time is now.

The indolent non-Hodgkin lymphomas (i-NHLs) are characterised by ‘indolent’ clinical behaviour with slow growth and prolonged natural history. The watchful waiting (WW) strategy is a frequently employed treatment option in these patients. This implies a strict monitoring by imaging examinations, including 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) and CT. A major concern is radiation exposure due to regularly monitoring by conventional imaging procedures. Several studies have demonstrated the reliability of whole-body magnetic resonance imaging (WB-MRI) for lymphoma staging. WB-MRI could be useful for active surveillance in i-NHLs providing the …

A Novel System for Multi-level Crohn’s Disease Classification and Grading Based on a Multiclass Support Vector Machine

Crohn’s disease (CD) is a chronic inflammatory condition of the gastrointestinal tract that can highly alter patient’s quality of life. Diagnostic imaging, such as Enterography Magnetic Resonance Imaging (E-MRI), provides crucial information for CD activity assessment. Automatic learning methods play a fundamental role in the classification of CD and allow to avoid the long and expensive manual classification process by radiologists. This paper presents a novel classification method that uses a multiclass Support Vector Machine (SVM) based on a Radial Basis Function (RBF) kernel for the grading of CD inflammatory activity. To validate the system, we have used a dataset composed of 800 E-MRI…

Immunotherapy for recurrent ovarian cancer: a further piece of the puzzle or a striking strategy?

Introduction: Treatment of ovarian cancer has been long standardized with the inclusion of surgery and chemotherapy based on platinum and taxanes, this strategy reaching high remission rates. However, when this treatment fails, further options are available with little benefit. Since ovarian cancer has specific immunologic features, actually immunotherapy is under evalua- 15 tion to overcome treatment failure in patients experiencing recurrence. Areas covered: Immunogenicity of ovarian cancer and its relationship with clinical outcomes is briefly reviewed. The kinds of immunotherapeutic strategies are summarized. The clinical trials investigating immunotherapy in recurrent ovarian cancer pa…

Hepatocellular and Fibrolamellar Carcinoma

G. Brancatelli, MD; M. Midiri, MD; R. Lagalla, MD Department of Radiology, Policlinico Universitario, Via del Vespro 127, 90127 Palermo, Italy M. P. Federle, MD Department of Radiology, Abdominal Imaging Offi ces, University of Pittsburgh Medical Center, Room 4660, CHP, MT, 200 Lothrop Street, Pittsburgh, PA 15213, USA V. Vilgrain, MD Department of Radiology, Hospital Beaujon, Avenue Du General Leclerc 100, 92118 Clichy, France L. Grazioli, MD Department of Radiology, University of Brescia, Spedali Civili di Brescia, Piazzale Spedali Civili 1, 25023 Brescia, Italy CONTENTS

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

RISONANZA MAGNETICA (RM) MORFOLOGICA E FUNZIONALE NELLO STUDIO DELL'ADENOCARCINOMA PROSTATICO (CAP)

Obiettivi didattici. Illustrare i reperti morfologici e funzionali del CaP, all'imaging RM. Introduzione. La RM è una metodica fondamentale nello studio del CaP; oltre all'imaging morfologico, permette importanti acquisizioni funzionali che aumentano la sua performance diagnostica. Tecnica d'esame. Lo studio RM della prostata prevede sequenze assiali t1, assiali, coronali e sagittali T2, DWI, sequenze spettroscopiche e sequenze perfusioni (GE T1w 3d fat-sat). In T1 la prostata ha intensità di segnale medio-bassa omogenea, senza possibilità di distinzione dell'anatomia zona e ghiandolare o d'identificazione di eventuali CaP. Queste sequenze permettono la visualizzazione di eventuali residui …

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"

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

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

Cardiac and hepatic iron and ejection fraction in thalassemia major: Multicentre prospective comparison of combined Deferiprone and Deferoxamine therapy against Deferiprone or Deferoxamine Monotherapy

Background: Due to the limited data available in literature, the aim of this multi-centre study was to prospectively compare in thalassemia major (TM) patients the efficacy of combined deferiprone (DFP) and deferoxamine (DFO) regimen versus either DFP and DFO in monotherapy by cardiovascular magnetic resonance (CMR) over a follow up of 18 months. Methods: Among the first 1135 TM patients in the MIOT (Myocardial Iron Overload in Thalassemia) network, we evaluated those who had received either combined regimen (DFO + DFP, N=51) or DFP (N=39) and DFO (N=74) monotherapies between the two CMR scans. Iron overload was measured by T2* multiecho technique. Biventricular function parameters were qua…

Radiographic Features with Pathological Correlation in Cerebral Amyloid Inflammatory Vasculopathy A Case Report

Cerebral Amyloid Angiopathy (CAA) is characterized by deposit of β-amyloid protein in the cortical and leptomeningeal arteries. It tends to increase in prevalence with advancing age and seems to have slight predilection for temporal, parietal and occipital lobes. It has recently been identified an inflammatory form of this angiophaty. This report describes a case presenting as an inflammatory vasculitis-perivasculitis form successfully treated with steroids and discuss about typical features and findings of this condition.

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

Ernie della parete addominale ed ernie interne: ruolo della tcmd nella gestione clinica del paziente.

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

Utility of Multi-Slice Computed Tomography Coronary Angiography to Evaluate Coronary Artery Bypass Graft Patency

Improved T2* assessment in liver iron overload by magnetic resonance imaging.

In the clinical MRI practice, it is common to assess liver iron overload by T2* multi-echo gradient-echo images. However, there is no full consensus about the best image analysis approach for the T2* measurements. The currently used methods involve manual drawing of a region of interest (ROI) within MR images of the liver. Evaluation of a representative liver T2* value is done by fitting an appropriate model to the signal decay within the ROIs vs. the echo time. The resulting T2* value may depend on both ROI placement and choice of the signal decay model. The aim of this study was to understand how the choice of the analysis methodology may affect the accuracy of T2* measurements. A softwar…

Microchimerism in multiple sclerosis: The association between sex of offspring and MRI features in women with multiple sclerosis

AimsDuring pregnancy, fetal cells can migrate to the mother via blood circulation. A percentage of these cells survive in maternal tissues for decades generating a population of fetal microchimeric cells (fMCs), whose biological role is unclear. The aim of this study was to investigate the association between the sex of offspring, an indirect marker of fMCs, and magnetic resonance imaging (MRI) features in women with multiple sclerosis (MS).MethodsWe recruited 26 nulliparous MS patients (NPp), 20 patients with at least one male son (XYp), and 8 patients with only daughters (XXp). Each patient underwent brain MR scan to acquire 3D-T2w FLAIR FatSat and 3D-T1w FSPGR/TFE. Lesion Segmentation To…

MR Signal Changes as Predictor of Pancreas Iron Overload and Impairment in Secondary Hemochromatosis

dc.description.abstract

Airway wall thickness by HRCT in patients with COPD.

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

Diffusion weighted magnetic resonance imaging at 1.5 Tesla in paediatric patients with Crohn's disease

Aim of our study was to investigate role of ADC values at b=0, 500, 800, and at multi-b in the evaluation of PCD

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

Imaging of complications of muscle tears.

Valutazione del dolore lombare con RM dedicata in ortostatismo. Esperienza preliminare.

SCOPO: Valutare l’utilità dell’esame sotto-carico della colonna lombare mediante una RM dedicata in pazienti con evidenza clinica di dolore lombare. DISEGNO DELLO STUDIO: Prospettico. MATERIALI E METODI: Nel periodo compreso tra agosto 2008 e luglio 2009, 40 pazienti con evidenza clinica di dolore lombare (gruppo A) ed uno stesso numero di volontari sani (gruppo B) sono stati esaminati mediante RM della colonna lombare con macchina dedicata da 0,25 Tesla (G-Scan, Esaote Spa, Genova, Italia). Sono state acquisite, con bobina ricevente dedicata per la colonna lombare, sequenze sul piano sagittale ed assiale SE-T1 e FSE-T2 pesate, sia in posizione supina che sotto-carico. Tre radiologi, in cie…

The lacrimal gland herniation role in the Graves’ orbitopathy

To evaluate the LG involvement, through the measurement of the LG herniation by of magnetic resonance imaging (MRI), in patients with different GO activity

Key-points to evaluate correctly the placement of umbilical venous catheters in infants on frontal radiographs

Provide basic key-points to evaluate placement of umbilical venous catheters (UVC) using a simplified flow-chart in resident radiologist.

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…

The Videofluorographic Swallowing Study in Rheumatologic Diseases: A Comprehensive Review

Autoimmune connective tissue diseases are a heterogeneous group of pathologies that affect about 10% of world population with chronic evolution in 20%–80%. Inflammation in autoimmune diseases may lead to serious damage to other organs including the gastrointestinal tract. Gastrointestinal tract involvement in these patients may also due to both a direct action of antibodies against organs and pharmacological therapies. Dysphagia is one of the most important symptom, and it is caused by failure of the swallowing function and may lead to aspiration pneumonia, malnutrition, dehydration, weight loss, and airway obstruction. The videofluorographic swallowing study is a key diagnostic tool in the…

Transcranial Magnetic Resonance-Guided Focused Ultrasound Surgery for Brain Tumor Ablation: Are We Ready for This Challenging Treatment?

The treatment of high-grade gliomas (HGGs) remains a challenge for modern therapy. The prognosis for these patients has been poor. The median patient survival after diagnosis has been ∼1 year with surgery and/or radiotherapy and temozolomide.1 The need for a histological diagnosis of tumor tissue in each case and the importance of decompression in symptomatic patients are well established, and extensive surgical resection has been shown to significantly prolong survival. Several factors play a role in the prognosis of patients with HGG, including age, performance status using the Karnofsky performance scale, and the extent of resection.2, 3 At present, the standard therapy for HHG consists …

Imaging approach for evaluation of focal liver lesions

Focal liver lesions are common in the general population. Radiology (imaging) plays a pivotal role for the diagnosis, staging, treatment planning, and follow-up of focal liver lesions. To maximize lesion detection and characterization, imaging needs to be performed with appropriate equipment by using protocols carefully designed on the basis of the underlying clinical context. In addition, the decision of an imaging modality cannot be based on the diagnostic accuracy of an imaging test solely but must also consider patient safety and cost-effectiveness.

Splenic Graulomatosis

Learning objectives Background Findings and procedure details Conclusion Personal information References

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

ACCURATEZZA DIAGNOSTICA DELLA TC 40 STRATI IN PAZIENTI CON DOLORE TORACICO

Cirrhosis: CT and MR imaging evaluation

In this article, we present the CT and MR imaging characteristics of the cirrhotic liver. We describe the altered liver morphology in different forms of viral, alcoholic and autoimmune end-stage liver disease. We present the spectrum of imaging findings in portal hypertension, such as splenomegaly, ascites and varices. We describe the patchy and lacelike patterns of fibrosis, along with the focal confluent form. The process of hepatocarcinogenesis is detailed, from regenerative to dysplastic nodules to overt hepatocellular carcinoma. Different types of non-neoplastic focal liver lesions occurring in the cirrhotic liver are discussed, including arterially enhancing nodules, hemangiomas and p…

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

Optimizing diagnostic approach to drug-induced liver injury

Drug-induced liver injury (DILI) is often a trial even to expert clinicians, because sometimes diagnosis is not easy to be made. Guidelines of the American College of Gastroenterology (ACG) yielded in 2014, help to better understand the problem. The diagnosis of DILI is made through a detailed evaluation of clinical, serological, radiological and histological aspects. Biochemical data include liver function tests that allow to assess the pattern of damage, such as hepatocellular, cholestatic and mixed liver injury; serological data include testing for major and possibly minor hepatotropic viruses, non-organ specific autoantibodies. Clinical scenario might include jaundice, nausea, vomiting …

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

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

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…

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

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

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

Aspetti delle lesioni cistiche epatiche con TC ed RM obiettivi

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…

Computed tomography coronary angiography in asymptomatic patients

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

Clinical support in radiation therapy scenarios: MR brain tumor segmentation using an unsupervised fuzzy C-Means clustering technique

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

Diffuse Liver Diseases: Role of imaging

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

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

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

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…

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.…

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

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

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

Incremental value and safety of oral ivabradine for heart rate reduction in computed tomography coronary angiography

Background: Heart rate (HR) reduction is essential to achieve optimal image quality and diagnostic accuracy with computed tomography coronary angiography (CTCA). Administration of ivabradine could be an attractive alternative to beta-blockade to reduce HR. Methods: One-hundred-twenty-three patients referred for CTCA were prospectively enrolled. Patients were divided in two groups depending on the absence or presence of chronic beta-blockade treatment. Within the two groups patients were randomized to either no additional premedication or oral ivabradine for 5 days prior to CTCA. In presence of chronic beta-blockade therapy it was shifted to atenolol 50 mg twice a day for 5 days prior to CTC…

COMPARATIVE EVALUATION OF DATA PREPROCESSING SOFTWARE TOOLS TO INCREASE EFFICIENCY AND ACCURACY IN DIFFUSION KURTOSIS IMAGING

Introduction: Diffusion tensor imaging (DTI) is the most commonly used technique to extract microstructural features from a set of diffusionweighted images. In addition to the metrics obtained with DTI, diffusion kurtosis imaging (DKI) can provide non-Gaussian diffusion measures by means of the kurtosis tensor. DKI has shown to be more sensitive to tissue microstructural changes in both normal and pathological neural tissue. In a clinical setting, however, these benefits are often nullified by numerous acquisition artifacts. The aim of this study was compare two preprocessing software for DTI apply to DKI. Also, the major preprocessing, processing and post-processing procedures applied to D…

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

ANOMALIE DI MOVIMENTO DEL VENTRICOLO SINISTRO NEI PAZIENTI CON TALASSEMIA MAJOR

tiroide diagnostica per immagini e approccio clinico ragionato

MRgFUS Uterine Fibroids treatments in Sicily: Preliminary Results and comparison of a Semi-Automatic and manual contouring

Background: Traditional surgery for uterine fibroids treatments (e.g. myomectomy, hysterectomy) offers very invasive therapeutic approaches, which not always preserve reproductive potential of the woman. MRgFUS (MR guided Focused UltraSound) is a new and non-invasive technique for uterine fibroids treatment, not requiring hospitalization and recovery time [1]. On June 2011 and July 2012 the first treatments were started at HSR-Giglio Hospital in Cefalù and at University Hospital (DIBIMEF) in Palermo. An initial assessment of MRgFUS treatment was made by computing the thermally-ablated volume of uterine fibroid. This volume was evaluated considering the NPV (Non Perfused Volume) on a post-t…

The “geographic” liver

Alterations of the beneficial effect of deep inspiration in scleroderma: relationships between lung function and imaging.

&lt;i&gt;Background:&lt;/i&gt; It has been postulated that the beneficial effects of deep inspiration are dependent on the magnitude of airway distension by virtue of airway to parenchyma interdependence. &lt;i&gt;Objective:&lt;/i&gt; This study was designed to examine whether the changes that occur in pulmonary fibrosis affect the beneficial effect of deep inspiration. &lt;i&gt;Methods:&lt;/i&gt; Thirty-one subjects with scleroderma underwent lung volume and diffusion capacity assessment as well as high-resolution computed tomography. To assess the effect of deep inspiration, each subject underwent methacholine provocations in the absence of deep breaths. When the targeted change in lung f…

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…

Multiplanar and Multiparametric MR Enterography in Crohn’s disease

Learning objectives Background Findings and procedure details Conclusion Personal information References

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 …

Evaluation of the efficacy of oral deferiprone in beta-thalassemia major by multislice multiecho T2*.

Objectives: Oral deferiprone (L1) appears to be promising in the treatment of beta-thalassemia major (TM) patients. T2* magnetic resonance imaging (MRI) with a single measurement in the mid-ventricular septum was validated as a quantitative evaluation of myocardial iron overload. Previous studies suggested a marked heterogeneity of iron distribution in the myocardium. We set up a multislice multiecho T2* MRI for the detection of this heterogeneity. The aim of our study was to investigate differences between the L1 vs. the subcutaneous desferrioxamine (DF)-treated patients using this new approach.Methods: Thirty-six beta-TM patients (age 29 +/- 8 yr) underwent MRI. Eighteen patients received…

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

Prevalence of coronary artery intramyocardial course in a large population of clinical patients detected by multislice computed tomography coronary angiography

Background: Intramyocardial course, an inborn coronary anomaly, is defined as a segment of a major epicardial coronary artery that runs intramurally through the myocardium; in particular, we distinguish myocardial bridging, in which the vessel returns to an epicardial position after the muscle bridge, and intramyocardial course, which is described as a vessel running and ending in the myocardium. Purpose: To evaluate the prevalence of myocardial bridging and intramyocardial course of coronary arteries as defined by multidetector computed tomography (MDCT) angiography. Material and Methods: The study population consisted of 242 consecutive patients (211 men, 31 women; mean age 59±6 years) w…

ESAME RADIOLOGICO DEL TORACE NELL’INVECCHIAMENTO CARDIACO

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…

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

MRI Enteroclysis and Enterography

Magnetic Resonance is actually the most complete and less invasive imaging technique in the evaluation of Crohn’s disease. Compared to Computed Tomography and Ultrasound, Magnetic Resonance allows both a morphological and qualitative evaluation of the disease at the same time, thus allowing an evaluation of its extension in the gastrointestinal tract and of its grade of activity, obtaining an accurate relation with the clinical status of the patient. This is possible thanks to its intrinsic characteristics, as multiplanarity, high contrast resolution, and the possibility to make a functional assessment; moreover, there is no use of ionizing radiation. For all these reasons, this technique h…

Imaging techniques for the vulnerable coronary plaque

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

Interventistica eco-guidata per l’articolazione d’anca

Lo scopo di questo lavoro è di rivedere le principali applicazioni della interventistica eco-guidata d’anca, descrivendone le indicazioni e la metodologia. L’ecografia è una metodica considerata sicura per i pazienti, in quanto non è stato dimostrato un possibile danno dovuto all’energia trasmessa dagli ultrasuoni ai tessuti del paziente, contrariamente alle metodiche che fanno uso di radiazioni ionizzanti, come la radiografia convenzionale e la tomografia computerizzata. Inoltre, l’ecografia risulta rapida ed efficace nel guidare l’ago verso la sede voluta evitando di intercettare strutture vascolari e/o nervose, consentendo quindi una maggiore sicurezza, rispetto alle tecniche interventis…

Cirrhosis: CT and MR imaging evaluation.

In this article, we present the CT and MR imaging characteristics of the cirrhotic liver. We describe the altered liver morphology in different forms of viral, alcoholic and autoimmune end-stage liver disease. We present the spectrum of imaging findings in portal hypertension, such as splenomegaly, ascites and varices. We describe the patchy and lacelike patterns of fibrosis, along with the focal confluent form. The process of hepatocarcinogenesis is detailed, from regenerative to dysplastic nodules to overt hepatocellular carcinoma. Different types of non-neoplastic focal liver lesions occurring in the cirrhotic liver are discussed, including arterially enhancing nodules, hemangiomas and p…

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

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

Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for the Treatment of Symptomatic Uterine Fibroids

Uterine fibroids, the most common benign tumor in women of childbearing age, may cause symptoms including pelvic pain, menorrhagia, dysmenorrhea, pressure, urinary symptoms, and infertility. Various approaches are available to treat symptomatic uterine fibroids. Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) represents a recently introduced noninvasive safe and effective technique that can be performed without general anesthesia, in an outpatient setting. We review the principles of MRgFUS, describing patient selection criteria for the treatments performed at our center and we present a series of five selected patients with symptomatic uterine fibroids treated with this not y…

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

Edema della porzione supero-laterale del corpo adiposo di Hoffa: associazione con malallineamento o conflitto femoro-rotuleo.

OBIETTIVO. Giovani pazienti che presentano dolore al ginocchio hanno spesso malallineamento femoro-rotuleo o anomalie da conflitto. Vi è una relativa scarsità di letteratura sull'incidenza e il significato dell'edema legato al conflitto del versante supero-laterale del corpo adiposo di Hoffa in questi casi. Il nostro studio è stato disegnato per valutare sistematicamente la correlazione dell'edema della porzione supero-laterale del corpo adiposo di Hoffa con diversi parametri anatomici della morfologia trocleare e dell'allineamento della rotula. MATERIALI E METODI. Abbiamo riesaminato in maniera retrospettiva 50 esami RM di ginocchio di 47 pazienti, eseguiti nel periodo gennaio 2011-marzo 2…

Thoracic examination in cardiac aging

CT and MR Imaging Evaluation of Hepatic Adenoma

Hepatic adenoma is a rare benign epithelial tumor that is usually encountered in young women who use oral contraceptives. It is clinically significant because of the risk of hemorrhage and of its low-grade malignancy potential. Adenomas usually are mildly hypervascular at contrast-enhanced CT and MR imaging, and heterogeneous due to the presence of hemorrhage, necrosis, calcifications and fat. The objective of our study was to illustrate the CT and MR imaging findings of hepatic adenoma.

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 …

Role of high-resolution ultrasonography without and with real-time spatial compound imaging in evaluating the injured posterior cruciate ligament: preliminary study.

This study sought to compare high-resolution ultrasonography (HRUS) without and with compound imaging in evaluating the injured posterior cruciate ligament (PCL). Thirteen patients with a magnetic resonance imaging (MRI) diagnosis of PCL lesions (ten acute and three chronic) and 20 healthy controls underwent conventional and compound HRUS performed by the same radiologist who was blinded to the subjects' case-control status. The PCL was scanned in a longitudinal direction in all cases. HRUS images were assessed for PCL thickness by two other radiologists blinded to the number and type of PCL injury. PCLs were classified as normal or injured, and the latter as having acute or chronic injurie…

Validation of lung densitometry threshold at CT for the distinction between senile lung and emphysema in elderly subjects

Background and Aims. An ageing lung is characterised by distal airspace enlargement without alveolar wall destruction: therefore the anatomical distinction between senile lung and emphysema is clear-cut. In clinical settings the definition of precise boundaries between normalcy and pathology is more difficult with the risk of overdiagnosis. CT is an important diagnostic advancement in the field of COPD. Most methods for the evaluation of emphysema are based on the detection and measurement of areas characterised by a density level below a threshold assumed to characterize parenchymal destruction. Methods. Our retrospective study included 47 healthy subjects (65-91 years), 36 never smokers a…

The loss of the beneficial effect of deep inspiration (DI) in COPD is associated with severity of disease

RELATIONSHIP BETWEEN BRAIN ATROPHY AND NATALIZUMAB THERAPY IN THE TREATMENT OF MULTIPLE SCLEROSIS

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

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

Gamma Knife treatment planning: MR brain tumor segmentation and volume measurement based on unsupervised Fuzzy C-Means clustering

Nowadays, radiation treatment is beginning to intensively use MRI thanks to its greater ability to discriminate healthy and diseased soft-tissues. Leksell Gamma Knife® is a radio-surgical device, used to treat different brain lesions, which are often inaccessible for conventional surgery, such as benign or malignant tumors. Currently, the target to be treated with radiation therapy is contoured with slice-by-slice manual segmentation on MR datasets. This approach makes the segmentation procedure time consuming and operator-dependent. The repeatability of the tumor boundary delineation may be ensured only by using automatic or semiautomatic methods, supporting clinicians in the treatment pla…

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

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.

Deferasirox, deferiprone and desferrioxamine treatment in thalassemia major patients: cardiac iron and function comparison determined by quantitative magnetic resonance imaging

Background Oral deferiprone was suggested to be more effective than subcutaneous desferrioxamine for removing heart iron. Oral once-daily chelator deferasirox has recently been made commercially available but its long-term efficacy on cardiac iron and function has not yet been established. Our study aimed to compare the effectiveness of deferasirox, deferiprone and desferrioxamine on myocardial and liver iron concentrations and bi-ventricular function in thalassemia major patients by means of quantitative magnetic resonance imaging. Design and Methods From the first 550 thalassemia subjects enrolled in the Myocardial Iron Overload in Thalassemia network, we retrospectively selected thalasse…

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

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

Clinical and prognostic value of 18F-FDG-PET/CT in restaging of pancreatic cancer

Aim The aim of this retrospective multicentre study was to evaluate the clinical and prognostic effect of fluorine-18-fluorodeoxyglucose (18F-FDG)-PET/computed tomography (CT) in the restaging process of pancreatic cancer (PC). Materials and methods Data from patients treated for primary PC, who underwent18F-FDG-PET/CT for suspicious of disease progression, were collected. Accuracy was assessed employing conventional diagnostic procedures, multidisciplinary team case notes, further18F-FDG-PET/CT scans and/or follow-up. Receiver operating characteristic curve and likelihood ratio (LR+/-) analyses were used for completion of accuracy definition. Progression-free survival (PFS) and overall sur…

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…

Chirurgia trans-cranica mediante ultrasuoni focalizzati ad alta intensità su guida RM: esperienza preliminare a 1,5T

Da qualche anno la chirurgia mediante ultrasuoni focalizzati ad alta intensità guidati da Risonanza Magnetica (Magnetic Resonance guided Focused Ultrasound Surgery, MRgFUS) si sta diffondendo anche in Italia per la palliazione del dolore da metastasi ossee, per il trattamento di tumori ossei primitivi (benigni e non), dei fibromi e dell’adenomiosi uterina; sono già stati inoltre pubblicati i risultati preliminari del trattamento di alcuni tumori epatici, pancreatici, prostatici e della mammella mediante MRgFUS. Questa innovativa tecnica prevede l’utilizzo di un’apparecchiatura di Risonanza Magnetica per il monitoraggio della procedura e sfrutta le caratteristiche fisico- meccaniche degli …

“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

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

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

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

CT and MR imaging of chemotherapy-induced hepatopathy.

Chemotherapy-induced hepatopathy includes a wide variety of parenchymal and vascular hepatic changes on imaging, including diffuse or focal hepatopathies (i.e. hepatitis, steatosis, fibrosis, pseudocirrhosis, or sinusoidal obstruction). These changes can profoundly alter the hepatic parenchyma on imaging and result in both false negative and false-positive diagnoses of hepatic metastases and lead to errors in patient management strategies. It is therefore important for radiologists to have a comprehensive knowledge of the imaging patterns that may develop following chemotherapy. The purpose of this review is to explore the broad spectrum of hepatic parenchymal and vascular chemotherapy-indu…

Current role of computed tomography-guided transthoracic needle biopsy of metastatic lung lesions.

ABSTRACT  Aim: As part of the Catania symposium on lung metastasectomy we reviewed our practice of computed tomography (CT)-guided percutaneous transthoracic needle biopsy of pulmonary metastatic lesions with particular emphasis on diagnostic accuracy and nature of complications lesions. Materials &amp; methods: 25 patients with metastatic lesions of the lung have been evaluated between May 2010 and February 2014. Inclusion criteria consisted of patients with histologically confirmed, metastatic disease of the lung, those receiving a CT-guided needle biopsy, were at least 18 years of age; and with adequate hepatic, renal and hematological function. We recorded also the size of the sampled …

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…

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

Introducing 1,5 T MRgFUS

MRgFUS is a new noninvasive thermal ablation method, consisting of a high focused ultrasound beam and a MR scanner for imaging and real-time thermal mapping. For decades, therapeutic transcranial ultrasound (tcMRgFUS) was assumed impossible. Novel technology using high-power phased array transducers and multiple channel driving electronics enabled a sharp focal point in the planned target through the intact skull allowing the use of this innovative technology for functional neurosurgery. Preliminary results have been published with systems operating with 3T MR units on patients with neurologic disorders such as essential tremor, tremor dominant idiopathic Parkinson's disease and neuropathic…

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…

Superior Mesenteric Artery Syndrome: Clinical, Endoscopic, and Radiological Findings.

Background. The superior mesenteric artery (SMA) syndrome is a rare entity presenting with upper gastrointestinal tract obstruction and weight loss. Studies to determine the optimal methods of diagnosis and treatment are required. Aims and Methods. This study aims at analyzing the clinical presentation, diagnosis, and management of SMA syndrome. Ten cases of SMA syndrome out of 2074 esophagogastroduodenoscopies were suspected. A contrast-enhanced computed tomography (CECT) scan was performed to confirm the diagnosis. After, a gastroenterologist and a nutritionist personalized the therapy. Furthermore, we compared the demographical, clinical, endoscopic, and radiological parameters of these …

Role of virtopsy in the post-mortem diagnosis of drowning.

Purpose: Due to admitted limits of autopsy-based studies in the diagnosis of drowning, virtopsy is considered the new imaging horizon in these post-mortem studies. The aim of our study was to evaluate the role of virtopsy performed through computed tomography (CT) in the forensic diagnosis of drowning. Materials and methods: We retrospectively examined the CT data of four cadavers recovered from sea water and suspected to have died by drowning. Each patient underwent a full-body post-mortem CT scan, and then a traditional autopsy. Conclusion: To date, there are no autopsy findings pathognomonic of drowning. This study proves that virtopsy is a useful tool in the diagnosis of drowning in tha…

Anatomic variants of the biliary tree at MRCP: still too rarely reported!

Aims and objectives Methods and materials Results Conclusion Personal information References

INTRACRANICAL HEMANGIOPERICYTOMA: CASE REPORT AND REVIEW OF LITERATURE

PURPOSE: We present a case of intracranical hemangiopericytoma (HPC) in a patient with migraine (male, 49 years old), who also presented mental confusion and partial left sensorimotor syndrome. We will also provide some elements regarding the international classification of this rare and highly vascularized mesenchymal tumor, and will consider possible differential diagnosis with other more common extra-axial masses. METHODS: After a preliminary examination in ER, patient underwent to head CT examination and was then transferred to the neurosurgical unit. The day after a brain MR examination was performed using advanced techniques too (PWI, and MRS); before surgery also functional MR imagin…

TIROIDE

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

Aims and objectives Methods and materials Results Conclusion Personal information References

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…

LESIONI REVERSIBILI DELL’IPPOCAMPO IN UN CASO DI AMNESIA GLOBALE TRANSITORIA

SCOPO DEL LAVORO: Lo scopo di questo lavoro è documentare un caso di Amnesia Globale Transitoria (Transient Global Amnesia, TGA) in un paziente emicranico di sesso maschile di 52 anni con anamnesi negativa per epilessia, disturbi psichiatrici, traumi ed abusi di sostanze. Saranno inoltre effettuati dei cenni sull’epidemiologia e i meccanismi fisiopatologici oggi più accreditati nella letteratura scientifica più recente di questa controversa sindrome neurologica. MATERIALI E METODI: Poco dopo un forte stress emotivo il paziente non ricordava cosa avesse fatto durante il giorno e ripeteva incessantemente le stesse domande a cui erano comunque state date più volte delle risposte dai colleg…

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

The Bronchodilatory effect of deep inspiration (DI) in subjects with pulmonary fibrosis

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

Assessment of brain core temperature using MR DWI-thermometry in Alzheimer disease patients compared to healthy subjects

Purpose: To assess the brain core temperature of Alzheimer disease (AD) patients in comparison with healthy volunteers using diffusion-weighted thermometry. Materials and methods: Fourteen AD patients (3 men, 11 women; age range 60–81 years, mean age 73.8 ± 6.1 years) and 14 healthy volunteers, age and sex-matched (mean age 70.1 ± 6.9 years; range 62–84 years; 5 men, 9 women) underwent MR examination between February 2014 and March 2016. MR imaging studies were performed with a 1.5-T MR scanner. Brain core temperature (T: °C) was calculated using the following equation from the diffusion coefficient (D) in the lateral ventricular (LV) cerebrospinal fluid: T = 2256.74/ln (4.39221/D) − 273.15…

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…

Postmortem Computed Tomography: From Acquisition to Reporting

PMCT in a noninvasive, fast, and quite available method which coroners and forensic experts tend to use more and more often, especially when a crime is suspected. PMCT proved to be an excellent tool for detection and assessment of bone fracture injuries due to sharp trauma and bullet trajectories.

Intratumoral Haemorrhage Causing an Unusual Clinical Presentation of a Vestibular Schwannoma

We present a case of an elderly woman with no history of audiological disease with sudden onset of visual and hearing deficits associated with systemic clinical signs. On examination she had impairment of right CNs from V to X. CT and MR imaging demonstrated a cystic vestibular schwannoma with a rare intralesional fluid-fluid level correlated to a recent bleed. We include high quality MR images to show the acute impairment of the cranial nerves next to the tumour after acute bleeding. Our case report includes a voxel-based morphometry (VMB) analysis of the tumour that, as far as we know, has never been done before for such a tumour. VBM analysis was performed to calculate the hypothesized …

TIPS for Prevention of Recurrent Bleeding in Patients with Cirrhosis: Meta-analysis of Randomized Clinical Trials

To compare the effects of transjugular intrahepatic portosystemic shunt (TIPS) creation with those of endoscopic treatment with or without propranolol administration (i.e, conventional treatment) on recurrent bleeding, encephalopathy, and mortality by using meta-analysis of 11 published randomized clinical trials.Data from 11 relevant studies were retrieved by means of computerized and manual search. The combinability of the studies was assessed in terms of clinical and statistical criteria. Data were extracted on the basis of the intention-to-treat principle, and treatment effects were measured as risk differences between TIPS creation and conventional treatment. Pooled estimates were comp…

Valutazione della riduzione della distensibilità delle vie aeree in relazione alla gravità del quadro di broncopneumopatia cronica ostruttiva mediante Tc ad alta risoluzione.

NUCLEAR MAGNETIC RESONANCE RELAXOMETRY AND IMAGING FOR DOSIMETRY WITH AGAROSE FRICKE GEL

Introduction: Fricke Xylenol Gel (FXG) dosimetric system is based on the radiation induced oxidation of ferrous to ferric ions. In this kind of gels it can occur that ferrous and ferric ions diffuse in the gel matrix. To preserve the spatial distribution of the dose from diffusion, Fricke gels must be undergoing measurement within a few hours of their irradiation. Thus, the spatial integrity of the dose distribution in the Fricke gel is maintained. The oxidation of ferrous ions also causes a reduction of the longitudinal nuclear magnetic relaxation time which can be measured by means of nuclear magnetic resonance (NMR) instrumentation. In this work we performed NMR relaxometry and MR imagin…

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…

Acute traumatic acromionclavicular jointlesions: role of ultrasound versus conventional radiography

OC.03.2 THE PRESENCE OF WHITE MATTER LESIONS IS ASSOCIATED WITH THE HISTOLOGICAL SEVERITY OF NON-ALCOHOLIC FATTY LIVER DISEASE

Multislice multiecho T2* cardiac magnetic resonance for the detection of heterogeneous myocardial iron distribution in thalassaemia patients

The present study investigated myocardial T2* heterogeneity in thalassaemia major (TM) patients by cardiac magnetic resonance (CMR), to determine whether is related to inhomogeneous iron overload distribution. A total of 230 TM patients consecutively referred to our laboratory were studied retrospectively. Three short-axis views (basal, medium and apical) of the left ventricle (LV) were obtained by multislice multiecho T2* CMR. T2* segmental distribution was mapped on a 16-segment LV model. The level of heterogeneity of the T2* segmental distribution, evaluated by the coefficient of variation (CoV), was compared with that of a surrogate data set, to determine whether the inhomogeneous segme…

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…

CARATTERISTICHE NEURORADIOLOGICHE DI UN CASO DI SCLEROSI TUBEROSA DIAGNOSTICATO IN ETÀ ADULTA

SCOPO DEL LAVORO: presentiamo un caso di Sclerosi Tuberosa (Tuberous sclerosis complex, TSC; anche nota come Sindrome di Bourneville-Pringle) diagnosticato tardivamente grazie al sospetto posto dalle indagini neuroradiologiche eseguite in una paziente di 40 anni con in anamnesi ritardo mentale, crisi epilettiche e disturbi del visus.MATERIALI E METODI: la paziente si presenza alla nostra attenzione per un episodio di disorientamento e confusione mentale; dopo una prima valutazione in PS veniva eseguita una TC dell’encefalo in tecnica sequenziale (Siemens SOMATON AS+, 128 strati) e trasferita presso l’U.O.C. di Neurologia. In seguito, per una migliore caratterizzazione dei reperti descritti …

Pigmented villonodular bursitis (PVNB) in the medial gastrocnemius bursa:report of an unusual case.

INTRODUCTION: Pigmented villonodular synovitis (PVNS) represents an uncommon benign proliferative disorder that may involve the synovium of the joint diffusely or focally, or that may occur extraarticularly in a bursa (pigmented villonodular bursitis [PVNB]) or tendon sheath (pigmented villonodular tenosynovitis [PVNTS]). The knee, followed by the hip, is the most common location for PVNS or PVNB, whereas PVNTS occurs most often in the hand and foot. It primarily involves young adults, the peak age being between the second and fourth decade of life and appears with non-specific symptoms which mimic other pathologies, including traumatic knee injuries, thus often delaying the correct diagnos…

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…

Thoracic cardiovascular imaging with 16 row multislice computed tomography and retrospective ECG-gating.Technical note

MR IMAGING IN A CASE OF PRIMARY EPIPLOIC APPENDAGITIS IN A 12 YEARS GIRL

Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept

Background. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction.Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery.Results…

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

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

CT anatomy of the heart and classification in coronary segments.

Anatomia TC del cuore e classificazione in segmenti coronarici

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

RUOLO DEL COEFFICIENTE DI DIFFUSIONE APPARENTE (ADC) NELLO STUDIO DELLA PROSTATA IN RISONANZA MAGNETICA (RM)

Usefulness of quantitative peritumoural perfusion and proton spectroscopic magnetic resonance imaging evaluation in differentiating brain gliomas from solitary brain metastases

Objectives The purpose of our study was to evaluate whether peritumoural perfusion weighted and proton spectroscopic magnetic resonance imaging can be used in differentiating between primary gliomas and solitary metastases. Methods Ten low-grade gliomas, eight high-grade gliomas and 10 metastases were prospectively evaluated with magnetic resonance imaging, dynamic susceptibility contrast enhanced perfusion imaging and single-voxel proton magnetic resonance spectroscopy before surgical resection or stereotactic biopsy. Maximal relative cerebral blood volume values were calculated drawing three regions of interest of 2 cm2 in the non-enhancing peritumoural areas. Maximal relative cerebral bl…

Extrabiliary and extrapancreatic incidental findings on magnetic resonance cholangio-pancreatography: A single centre experience in 1000 patients.

Role of MSCT scan in management of patients with primary epiploic appendagitis; our experience

Purpose Methods and Materials Results Conclusion References Personal Information

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

causes of false positive interpretation for hepatocellular carcinoma in cirrhosis

3D reconstruction techniques made easy: know-how and pictures

Three-dimensional reconstructions represent a visual-based tool for illustrating the basis of three-dimensional post-processing such as interpolation, ray-casting, segmentation, percentage classification, gradient calculation, shading and illumination. The knowledge of the optimal scanning and reconstruction parameters facilitates the use of three-dimensional reconstruction techniques in clinical practise. The aim of this article is to explain the principles of multidimensional image processing in a pictorial way and the advantages and limitations of the different possibilities of 3D visualisation.

Using anatomic and metabolic imaging in stereotactic radio neuro-surgery treatments

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

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

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

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

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

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

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

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

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

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

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

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

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

Impact of coronary calcium score on diagnostic accuracy for the detection of significant coronary stenosis with multislice computed tomography angiography.

One hundred twenty patients in sinus rhythm with suspected coronary artery disease who underwent multislice computed tomography of the heart and conventional coronary angiography were retrospectively selected. The population was divided into 2 groups depending on their calcium score (CS) (e.g., low CS and high CS). The diagnostic accuracy of multislice computed tomographic scans for detecting significant lesions (>50% lumen reduction) in both groups was compared with quantitative coronary angiography. The sensitivity and specificity of multislice computed tomography were 90% and 92%, and 97% and 91% for low and high CS groups, respectively.

Hepatic enhancement in cirrhosis in the portal venous phase: what are the differences between gadoxetate disodium and gadobenate dimeglumine?

Purpose: To compare the level of parenchymal and portal venous enhancement in the portal venous phase (PVP) in cirrhotic patients undergoing gadoxetate disodium- and gadobenate dimeglumine-enhanced MRI. Methods: In this retrospective study, 84 cirrhotic patients (mean age ± SD: 66 ± 13 years) who underwent contrast-enhanced MRI with both gadoxetate disodium and gadobenate dimeglumine between 2012 and 2018 were included. Two readers measured signal intensities of hepatic parenchyma, portal vein and psoas muscle on precontrast and PVP. Relative enhancement (RE), image contrast, and portal vein-to-liver contrast difference were calculated. Intraindividual differences were compared with the Wil…

UTILITA’ DELL’ANGIOGRAFIA CORONARICA ESEGUITA MEDIANTE TOMOGRAFIA COMPUTERIZZATA MULTISTRATO NEL CONTROLLO DELLA PERVIETA’ DEL BYPASS AORTO-CORONARICO

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

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

Treatment of hepatocellular carcinoma: present and future

Hepatocellular carcinoma is a major health problem. It is the sixth most common cancer worldwide and the third most common cause of cancer-related death. Despite the availability of several treatment opportunities, diagnosis is still made in an advanced phase, limiting application of most therapeutic choices that currently are based on the Barcelona Clinic Cancer Liver Classification and include surgical resection, orthotopic liver transplantation and ablative methods for very early and early disease, arterial chemoembolization for intermediate stages and systemic therapy with sorafenib for advanced hepatocellular carcinoma. Thanks to novel advancements in knowledge of molecular pathogenesi…

Confronto tra aterosclerosi coronarica mediante CardioTC e aterosclerosi carotidea mediante ecocolorDoppler

Ruolo della RM whole body nell’identificazione di reperti incidentali in pazienti con linfoma.

Scopo: Il dibattito in merito ai reperti incidentali sta divenendo emergente in molti settori radiologici, quali l’ambico cardiaco, addominale, neurologico, senologico, pediatrico, soprattutto con metodiche quali la RM e la TC. Lo scopo del nostro studio è stato di valutare l’utilità della Risonanza Magnetica Whole Body (RM-WB) nell’identificazione di reperti incidentali in pazienti con linfoma. Materiali e metodi: Sono state revisionate le RM-WB eseguite su 114 pazienti (65 maschi; età mediana 45,2 anni, range 15-86) con diagnosi istologica di linfoma (47 Hodgkin, 67 Non-Hodgkin). I reperti incidentali sono stati classificati in tre classi: non significativi (classe 1), moderatamente signi…

Profilo di accettabilità dell'angiografia coronarica non invasiva mediante TC multistrato: per una medicina dalla parte del paziente.

Multiple sclerosis: prevalence of the ‘central vein’ sign in white matter lesions on gadolinium-enhanced susceptibility-weighted images

Aims To evaluate prospectively whether an intravenous gadolinium injection could improve the detection of the central vein sign on susceptibility-weighted imaging sequences obtained with a 1.5 T magnetic resonance scanner in patients with multiple sclerosis compared to unenhanced susceptibility-weighted images. Materials and methods This prospective, institution review board-approved study included 19 patients affected by multiple sclerosis (six men; 13 women; mean age 40.8 years, range 20–74 years). Patients had the relapsing–remitting clinical subtype in 95% of cases, and only one (5%) patient had the primary progressive clinical subtype of multiple sclerosis. T2-weighted images, fluid-at…

Impact of structured report on the quality of preoperative CT staging of pancreatic ductal adenocarcinoma: assessment of intra- and inter-reader variability

Purpose: To evaluate whether a structured radiology report improves the completeness of preoperative CT staging of pancreatic ductal adenocarcinoma (PDA) compared to conventional free-text reports. Methods: We retrospectively included 27 patients (mean age, 64 ± 11.1 years) referred for pancreatic preoperative CT scan for staging of PDA between 2015 and 2018 and in whom a diagnosis of pancreatic adenocarcinoma was ultimately confirmed. Four readers independently reported CT scans with both conventional free-text and structured reports. Differences in reported morphologic and vascular features with the two reports were assessed through McNemar Test. Intra-reader and inter-reader were calcula…

The role of PET radiomic features in prostate cancer: a systematic review

Aim: This systematic review aims to present the available evidence on the use of radiomic features (RFs) extracted from PET imaging in patients with prostate cancer (PCa). Materials and methods: A comprehensive literature search of studies on the utility of PET-derived RFs in patients with PCa was performed in the PubMed/MEDLINE database through February 24th, 2021 using the following search string: [“positron-emission tomography” (MeSh terms) OR “positron emission tomography computed tomography” (MeSh terms) OR “positron-emission tomography” (all fields) OR “positron emission tomography computed tomography” (all fields) OR “PET” (all fields)] AND [“radiomics” (all fields) OR “radiomic” (al…

The "spoke wheel" sign in mesenteric carcinoid.

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

A versatile ultrasound system for in vitro experiments

Objective One of the most difficult tasks to achieve with the available instrumentations used to study the interaction between ultrasound (US) and cellular model systems is to design an experiment, where only the effects of one physical parameter at a time is evaluated, while all the others are kept constant. The set-ups are usually custom-made, often by means of clinical instrument intended for a different therapeutic purpose. Furthermore, the results are not strictly comparable with others obtained with techniques considered standard in molecular and cellular biology at this time, because there is the need to use non-standard devices to contain biological samples. Sterility, as well as te…

Evaluation of a Support Vector Machine Based Method for Crohn’s Disease Classification

Crohn’s disease (CD) is a chronic, disabling inflammatory bowel disease that affects millions of people worldwide. CD diagnosis is a challenging issue that involves a combination of radiological, endoscopic, histological, and laboratory investigations. Medical imaging plays an important role in the clinical evaluation of CD. Enterography magnetic resonance imaging (E-MRI) has been proven to be a useful diagnostic tool for disease activity assessment. However, the manual classification process by expert radiologists is time-consuming and expensive. This paper proposes the evaluation of an automatic Support Vector Machine (SVM) based supervised learning method for CD classification. A real E-…

Classification and imaging of ankle impingement syndromes

Learning objectives Background Imaging findings OR Procedure details Conclusion Personal Information References

The cheating liver: imaging of focal steatosis and fatty sparing

ABSTRACT: Focal steatosis and fatty sparing are a frequent finding in liver imaging, and can mimic solid lesions. Liver regional variations in the degree of fat accumulation can be related to vascular anomalies, metabolic disorders, use of certain drugs or coexistence of hepatic masses. CT and MRI are the modalities of choice for the noninvasive diagnosis of hepatic steatosis. Knowledge of CT and MRI appearance of focal steatosis and fatty sparing is crucial for an accurate diagnosis, and to rule-out other pathologic processes. This paper will review the CT and MRI techniques for the diagnosis of hepatic steatosis and the CT and MRI features of common and uncommon causes of focal steatosis …

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).…

Direct and indirect involvement of HCV infection in the pathogenesis of myocardial fibrosis in Thalassemia Major

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

Intravenous Contrast Material for Cardiac Computed Tomography

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

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…

Radiomics and Prostate MRI: Current Role and Future Applications

Multiparametric prostate magnetic resonance imaging (mpMRI) is widely used as a triage test for men at a risk of prostate cancer. However, the traditional role of mpMRI was confined to prostate cancer staging. Radiomics is the quantitative extraction and analysis of minable data from medical images; it is emerging as a promising tool to detect and categorize prostate lesions. In this paper we review the role of radiomics applied to prostate mpMRI in detection and localization of prostate cancer, prediction of Gleason score and PI-RADS classification, prediction of extracapsular extension and of biochemical recurrence. We also provide a future perspective of artificial intelligence (machine …

Supero-Lateral Hoffa's Fat Edema: associazione con malallineamento o conflitto femoro-rotuleo

Airway Wall Thickness By HRCT Does Not Affect Airway Distensibility In Asthma And COPD

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

Chest CT in COVID-19 Pneumonia: Potentials and Limitations of Radiomics and Artificial Intelligence

SARS-CoV-2 epidemics has resulted in an unprecedented global health crisis causing a high number of deaths with pneumonia being the most common manifestation. Chest CT is the best imaging modality to identify pulmonary involvement, but unfortunately there are no pathognomonic features for COVID-19 pneumonia, since many other infectious and non-infectious diseases may cause similar alterations. The adoption of artificial intelligence in biomedical imaging has the potential to revolutionize the identification, management, and the patient’s outcome. If adequately validated, it could be used as a support with predictive and prognostic purposes in symptomatic patients but also as a screening tes…

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…

Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) for uterine fibroids: our experience on patients’ eligibility

Learning objectives Background Findings and procedure details Conclusion Personal information References

Contrazione attiva del quadricipite. Nuove possibilità nello studio RM del dolore anteriore del ginocchio.

OBIETTIVO: Valutare l’effetto della contrazione attiva del muscolo quadricipite a 30° di flessione del ginocchio, in pazienti con dolore anteriore, per una migliore classificazione del tilt patellare rispetto all’esame basale. MATERIALE E METODI: Da Marzo 2006 a Febbraio 2007 sono stati valutati 60 pazienti (43 M, 27 F) con dolore anteriore del ginocchio, e sottoposti ad esame RM del ginocchio (Artoscan-C, Esaote). L’articolazione femoro-rotulea è stata esaminata a 30° di flessione, sia a riposo che dopo contrazione attiva del quadricipite, nelle immagini assiali centrate sulla rotula. Sono stati misurati 3 tipi di angoli: angolo del tilt patellare (PTA), angolo del solco (SA), ed angolo di…

CONTRIBUTO DELLA RM PERFUSIONALE IN ASSOCIAZIONE ALLA SPETTROSCOPIA RM SINGLE VOXEL NELLA DEFINIZIONE DEL GRADING DEI GLIOMI CEREBRALI.

Small Bowel Perforations: What the Radiologist Needs to Know

The incidence of small bowel perforation is low but can develop from a variety of causes including Crohn disease, ischemic or bacterial enteritis, diverticulitis, bowel obstruction, volvulus, intussusception, trauma, and ingested foreign bodies. In contrast to gastroduodenal perforation, the amount of extraluminal air in small bowel perforation is small or absent in most cases. This article will illustrate the main aspects of small bowel perforation, focusing on anatomical reasons of radiological findings and in the evaluation of the site of perforation using plain film, ultrasound, and multidetector computed tomography equipments. In particular, the authors highlight the anatomic key notes…

EVALUATION OF RESPONSE IN MALIGNANT TUMORS TREATED WITH TARGETED AGENTS.

Learning objectives Background Findings and procedure details Conclusion Personal information References

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

Cardiac magnetic resonance versus echocardiography for the assessment of cardiac volumes and function in thalassemia major patients

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

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

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

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…

Imaging neuroradiologico funzionale 3-D per l'asportazione di un angioma cavernoso in area eloquente: case report e review della letteratura

Imaging neuroradiologico

The “caput medusae” sign in portal hypertension

Serum and fecal pancreatic enzymes in beta-thalassemia major

This study, using indirect tests, demonstrated that exocrine pancreatic function is impaired in a proportion of patients with beta-thalassemia major (TM), though this impairment is generally mild or moderate.Impaired structure and function of the exocrine pancreas has been reported in patients with Beta-thalassemia major.In this study we measured fecal fats and serum and fecal pancreatic enzymes in 30 patients (13 M, 17 F) with TM, mean age 22.1 yr (range 14-39) and compared them with those of a matched group of healthy controls. Results were correlated with age, serum ferritin, blood transfusion, and various nutritional parameters. Enzymes assays included: serum pancreatic amylase (PA), li…

Complications of hepatic echinococcosis: multimodality imaging approach

AbstractHydatid disease is a worldwide zoonosis endemic in many countries. Liver echinococcosis accounts for 60–75% of cases and may be responsible for a wide spectrum of complications in about one third of patients. Some of these complications are potentially life-threatening and require prompt diagnosis and urgent intervention. In this article, we present our experience with common and uncommon complications of hepatic hydatid cysts which include rupture, bacterial superinfection, and mass effect-related complications. Specifically, the aim of this review is to provide key imaging features and diagnostic clues to guide the imaging diagnosis using a multimodality imaging approach, includin…

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.

RUOLO DEL COEFFICIENTE APPARENTE DI DIFFUSIONE (ADC) NELLO STUDIO DELLA PROSTATA IN RISONANZA MAGNETICA (RM)

Materiali e Metodi: La nostra popolazione è costituita da 25 di età compresa tra 50 e 81 anni (media 63.95 +/- 9.54) sottoposti ad esame RM della prostata con apparecchiatura da 1.5 T mediante l'ausilio di bobina endorettale. Oltre al protocollo morfologico (T1w-T2w) , la valutazione spettroscopica e dinamica post-contrastografica, sono state acquisite sequenze DWI sul piano assiale con valori di b pari a 800/mm2. E' stato calcolato il valore di ADC in regioni di interesse poste in corrispondenza di aree di zona periferica (ZP) con aspetto normale ed aree che presentavano segnale ipointenso enne sequenze T2w e/o che mostravano restrizione della diffusione dell'acqua nelle sequenze DWI. All'…

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

Evaluation of supraspinatus tendon teras with elastosonography in comparison to US and MRI . Our experience

INTRODUCTION: Elastosonography is a new promising ultrasound tool that can evaluate soft-tissue elasticity, in particular of the tendons. The purpose of this study was to value the elasticity of the supraspinatus tendon in shoulders with clinically suspected unilateral rotator cuff tear, and to compare the findings with those of US and MRI. MATHERIALS AND METHODS: 36 shoulders of 18 patients (mean age 46 years; range: 32 – 58 years) were examined by Elastosonography using the EUB – Hitachi 7500 Japan. Electronic array transducer of 13 MHz was used. By Elastosonography, we have evaluated the tendon fibers with a seminquantitative score of different colors representing stiff tissue (blue) to …

Plantar fascia evaluation with a dedicated magnetic resonance scanner in weight-bearing position: our experience in patients with plantar fasciitis and in healthy volunteers.

Purpose. This study assessed the usefulness of upright weight-bearing examination of the ankle/hind foot performed with a dedicated magnetic resonance (MR)imaging scanner in the evaluation of the plantar fascia in healthy volunteers and in patients with clinical evidence of plantar fasciitis. Materials and methods. Between January and March 2009, 20 patients with clinical evidence of plantar fasciitis (group A) and a similar number of healthy volunteers (group B) underwent MR imaging of the ankle/hind foot in the upright weight-bearing and conventional supine position. A 0.25-Tesla MR scanner (G-Scan, Esaote SpA, Genoa, Italy) was used with a dedicated receiving coil for the ankle/hind foot…

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…

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…

Valutazione della fascia plantare con una RM dedicata in posizione ortostatica: esperienza preliminare in pazienti con fascite plantare ed in volontari sani

Obiettivo/Introduzione: Dimostrare l’utilità dell’esame sotto carico della caviglia eseguito con una macchina RM dedicata nella valutazione della fascia plantare in volontari sani ed in pazienti con evidenza clinica di fascite plantare. Materiali e Metodi: Due gruppi di 20 soggetti l’uno sono stati studiati mediante esame RM, eseguito nel periodo compreso tra Gennaio e Marzo 2009. Usando una bobina ricevente dedicata, abbiamo acquisito immagini spin echo T1 (SE-T1), 3D-steady state (3D-SSF) e short tau inversion recovery (STIR) mediante macchina RM da 0,25 Tesla (G-Scan, Esaote SpA, Genova, Italia), sia in posizione ortostatica che supina convenzionale. Risultati: In tutti i volontari sani …

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

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

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

Superior Canal Dehiscence: Multidetector-Row CT Evaluation

Nuclear magnetic resonance relaxometry and imaging for dosimetry with agarose Fricke gel

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

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

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…

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

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

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…

La pelvi operata: nuova anatomia e complicanza

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

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

Intraoperative Ultrasound: Emerging Technology and Novel Applications in Brain Tumor Surgery

Intraoperative ultrasound (IOUS) is becoming progressively more common during brain tumor surgery. We present data from our case series of brain tumor surgery performed with the aid of IOUS in order to identify IOUS advantages and crucial aspects that may improve the management of neurosurgical procedures for brain tumors. From January 2021 to September 2021, 17 patients with different brain tumors underwent brain tumor surgery aided by the use of IOUS. During surgery, the procedure was supported by the use of multiples ultrasonographic modalities in addition to standard B-mode: Doppler, color Doppler, elastosonography, and contrast-enhanced intraoperative ultrasound (CEUS). In selected cas…

Heart anatomy

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…

64-slice computed tomography coronary angiography : diagnostic accuracy in the real world.

Studio preliminare di parcellizzazione talamica per l’identificazione del target di trattamento applicato alle talamotomie trans-craniche mediante ultrasuoni focalizzati guidati da Risonanza Magnetica (tcMRgFUS) [Thalamic parcelization for target identification in trans-cranial MR-guided Focused UltraSound (tcMRgFUS) thalamotomies: a preliminary study]

Introduzione La tcMRgFUS consente di effettuare una vera e propria esplorazione neurofunzionale per confermare ed ottimizzare il target lesionale prima di indurre una lesione cerebrale permanete. La scelta del target di trattamento si basa tuttavia su coordinate stereotassiche che non tengono conto delle diversità anatomiche di ciascun individuo. L'ottimizzazione del target di trattamento viene effettuata sulla base del feedback del paziente durante la procedura stessa. Materiali e metodi È’ stato utilizzato uno scanner RM da 1.5T per acquisire sequenze morfologiche 3D e ultrastrutturali (DTI) in pazienti successivamente sottoposti a tcMRgFUS. È stata effettuata una segmentazione delle aree…

Chirurgia trans-cranica mediante ultrasuoni focalizzati ad alta intensità su guida rm: esperienza preliminare a 1,5T (primi 2 casi trattati)

Scopo del Lavoro Presentiamo i risultati preliminari ottenuti con la prima istallazione italiana di un’apparecchiatura per la neurochirurgia funzionale mediante ultrasuoni focalizzati ad alta intensità su guida RM (trans-cranial MRI-guided Focused Ultrasound Surgery, tcMRgFUS); si tratta tra l’altro della prima apparecchiatura tcMRgFUS al mondo mai installata su uno scanner RM da 1,5T. Tale apparecchiatura è attualmente certificata (CE ed FDA) per trattamenti di neurochirurgia funzionale in pazienti con tremore essenziale (Essential Tremor, ET), Parkinson idiopatico (Parkinson Disease, PD) unilaterale prevalentemente tremorigeno e dolore neuropatico (Neuropathic Pain, NP). Materiali e Metod…

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

Purpose Methods and Materials Results Conclusion References Personal Information

Imaging dell'emottisi non traumatica mediante TC Multistrato

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

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

Videofluorography swallow study of patients with systemic sclerosis

PURPOSE: This study was undertaken to evaluate the role of the videofluorographic (VFG) swallow study in patients with systemic sclerosis. MATERIALS AND METHODS: Over a 23-month period, 45 women (mean age 58 years, range 27-76 years) with a known diagnosis of systemic sclerosis and a history of dysphagia underwent a dynamic and morphological study of the oral, pharyngeal and oesophageal phases of swallowing with videofluorography. All examinations were performed with a remote-controlled digital C-arm device with 16-in image intensifier, 0.6- to 1.2-mm focal spot range and maximum tube voltage of 150 kVp in fluorography and 120 kVp in fluoroscopy. Cineradiographic sequences were acquired for…

Benign and malignant mimickers of infiltrative hepatocellular carcinoma: tips and tricks for differential diagnosis on CT and MRI

Hepatocellular carcinoma (HCC) may have an infiltrative appearance in about 8-20% of cases. Infiltrative HCC can be a challenging diagnosis and it is associated with the worst overall survival among HCC patients. Infiltrative HCC is characterized by the spread of multiple minute nodules throughout the liver, without a dominant one, ultimately resulting into macrovascular invasion. On CT and MRI, infiltrative HCC appears as an ill-defined, large mass, with variable degree of enhancement, and satellite neoplastic nodules in up to 52% of patients. On MRI, it may show restriction on diffusion weighted imaging, hyperintensity on T2- and hypointensity on T1-weighted images, and, if hepatobiliary …

MR imaging of bilateral paramedian thalamic and mesencephalic infarcts: A case report

We describe MR imaging of bilateral infarction of the paramedian portion of the mesencephalus and thalamus due to an occlusion of the Percheron artery. This entity is due to one of the anatomic variants of the perforating arteries supplying the thalamus and mesenchephalus. Clinically this kind of infarction presents with neurologic impairment as a disorder of consciousness, memory dysfunctions, various types of vertical gaze palsy and psychic changes, which need to be differentiated from delirium and coma. At MRI evaluation infarction of the paramedian portion of thalami and midbrain, with a “butterfly wings” pattern, was demonstrated as high signal intensity areas on FLAIR and FSE-T2W ima…

Ventricular arrhythmias in children : the usefulness of MRI

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

The value of serial MR imaging in the assessment of brain metastases volume control during stereotactic radiosurgery

Purpose: To evaluate early tumour control capabilities of Stereotactic Radiosurgery (SRS) in the treatment of brain metastasis and the role of follow-up MR imaging. Methods and Materials: MR imaging of 54 metastases in 31 patients treated with SRS who underwent follow-up MR imaging within 12 months were retrospectively reviewed. Tumours were characterized as either enlarged (>20% volume increase), stable (follow-up volume ±20% of the initial volume), or decreased (> 0% volume decrease). Results: Within the first 6 weeks following SRS a decrease was observed in 25 (52%) of the tumours in the extent of 63% in size. Tumour reduction varied according to histopathological subtype with 38% of non…

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

Prevalence and clinical significance of incidental findings on multiparametric prostate MRI.

Purpose: To assess the prevalence and clinical significance of incidental findings (IFs) detected at multiparametric prostate MRI examination. Materials and methods: Multiparametric prostate MRIs of 647 consecutive patients (mean age 67.1 ± 8.0 years) were retrospectively evaluated by two radiologists recording the presence of all extra-prostatic IFs. Findings were classified as related to or not related to genitourinary system and divided into three classes, according to their clinical significance, as follows: group 1, not significant or scarcely significant; group 2, moderately or potentially significant; and group 3, significant. Differences in distribution of IFs between patients ≤ 65 …

L'RFTA nel trattamento dell'epatocarcinoma su cirrosi

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

Ultrasuoni focalizzati ad alta intensità su guida RM (MRgFUS) per il trattamento dei fibromi uterini sintomatici: la nostra esperienza

I fibromi uterini rappresentano il più comune tumore benigno del tratto genitale femminile in età riproduttiva. Sebbene siano spesso del tutto asintomatici, in circa la metà dei casi possono essere responsabili di sintomi debilitanti quali menometrorragia, dismenorrea, anemia, dolore, pressione pelvica, disturbi urinari, costipazione, dispareunia ed infertilità. Diversi approcci sono oggi disponibili per il trattamento dei fibromi uterini, sia farmacologici che chirurgici; tra questi l’MRgFUS rappresenta, in casi selezionati, una tecnica sicura, efficace e non invasiva in grado di preservare la fertilità della donna. Tale tecnica combina la tecnologia della risonanza magnetica (RM), in…

Ultrasound-guided intervention for hip joint

The purpose of this work is to review the main applications of ultrasound-guided hip interventional procedures, describing the indications and methodology. Ultrasound is a method considered safe for patients, as it has not been shown a possible damage due to ultrasound energy transmitted towards the patient’s tissues, as opposed to methods that make use of ionizing radiation, such as conventional radiography and computed tomography. In addition, ultra- sound is quick and effective in guiding the needle to the desired location avoiding vascular and/or nerve structures, thus enabling greater security, compared to the techniques performed in interventional fluoroscopy, which also have the disa…

La rappresentazione delle informazioni

Abbiamo visto che il calcolatore rappresenta al suo interno dati numerici, indirizzi e istruzioni sotto forma di codici binari. Dovrebbe essere chiaro a questo punto che il sistema binario viene usato dai calcolatori non solo come sistema di numerazione, ma per rappresentare in forma codificata qualsiasi informazione. Si puo definire “alfabeto esterno” di un calcolatore l’insieme di caratteri alfanumerici che il calcolatore e in grado di leggere da un dispositivo di ingresso, rappresentare al suo interno, o stampare e visualizzare su un dispositivo di uscita. Fanno parte di questo alfabeto i seguenti caratteri: le 26 lettere dell’alfabeto, maiuscole o minuscole, o entrambe le 10 cifre decim…

Patologie renali chirurgiche

An Osirix based plug-in for the study of dimensional and densitometric changes of hepatic metastases on CT images

Aims and objectives Methods and materials Results Conclusion Personal information References

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…

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…

Usefulness of multislice computed tomography to assess patency of coronary artery stents versus conventional coronary angiography

BACKGROUND: The aim of the present study was to assess the in-stent restenosis and occlusion of coronary artery stents by multislice computed tomography (MSCT) compared with conventional coronary angiography in patients with atypical chest pain and not practicable/non-conclusive stress test. METHODS: Between December 2004 and March 2006, 81 patients were scheduled and of these 72 (65 men, mean age 61 years) with 90 stents underwent MSCT angiography using a 16-slice scanner, Toshiba Aquilion 16, 8-12 months after stent placement. RESULTS: Of the 90 stents, 71 (79%) could be assessed and 19 (21%) were excluded because the image quality at the stent level was incompatible with diagnostic asses…

Radiation risks knowledge in resident and fellow in paediatrics: a questionnaire survey

Background: Analyse through a multi-choice anonymous questionnaire the knowledge's level in paediatric residents and fellows in two different main Italian hospital, looking mainly to the information to patients and relatives related to risks of ionizing radiation used in common radiological investigations in children. Methods: 65 multi choice questionnaires were distributed to paediatric residents and fellows of two different hospitals, an University Hospital (A.O.U.P. "P. Giaccone"- University of Palermo) and a national reference centre for paediatrics (Ospedale Pediatrico Bambino Gesù - Rome). The questionnaire included twelve multiple-choice questions with the aim of analyzing the knowle…

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 …

Resting-State Functional Connectome in Patients with Brain Tumors Before and After Surgical Resection

Purpose: High-grade glioma surgery has evolved around the principal belief that a safe maximal tumor resection improves symptoms, quality of life, and survival. Mapping brain function has been recently improved by resting-state functional magnetic resonance imaging (rest-fMRI), a novel imaging technique that explores networks connectivity at “rest.” Methods: This prospective study analyzed 10 patients with high-grade glioma in whom rest-fMRI connectivity was assessed both in single-subject and in group analysis before and after surgery. Seed-based functional connectivity analysis was performed with CONN toolbox. Network identification focused on 8 major functional connectivity networks. A v…

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

Osteonecrosis in Hodgkin lymphoma treated by BEACOPP

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…

The “spoke wheel” sign in hepatic focal nodular hyperplasia

CLASSICS IN ABDOMINAL RADIOLOGY

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

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

Valutazione delle lesioni focali del tendine del sovraspinato con elastosonografia: confronto con ecografia B-mode e risonanza magnetica: esperienza personale.

Obiettivo. Scopo dello studio era valutare l’elasticità del tendine del sovraspinato nella spalla sintomatica di pazienti con sospetto clinico di rottura unilaterale della cuffia dei rotatori, e comparare i reperti riscontrati con quelli dell’ecografia convenzionale (ultrasound, US) e della risonanza magnetica (RM). Metodi. Nel periodo compreso tra gennaio e dicembre 2009 sono state esaminate da un radiologo entrambe le spalle di 58 pazienti (età media: 46 anni; range 32-58 anni) sia con modulo elastosonografico in real-time che in B-mode tramite uno stesso ecografo (EUB - Hitachi 7500), usando una sonda lineare a elevata frequenza (13 MHz). L’elasticità delle fibre tendinee del sovraspinat…

Dislocazione infero-mediale del frammento meniscale. Studio con risonanaza magnetica

Definire l'accuratezza diagnostica della Risonanza Magnetica (RM) nella diagnosi di dislocazione infero-mediale del frammento della fibrocartilagine meniscale, Materiale e metodi. Sono stati valutati retrospettivamente gli esami RM del ginocchio, effettuati nel periodo compreso tra dicembre 2002 ed aprile 2004, di 676 pazienti (eta media 32 anni) affetti da patologia traumatica del ginocchio e successivamente sottoposti ad artroscopia, al fine di identificare la presenza di una lesione meniscale a manico di secchio e della dislocazione infero-mediale del frammento meniscale. Gli esami RM sono stati eseguiti con un magnete superconduttivo da 0,5 T utilizzando una bobina ricevente/trasmittent…

Comparative evaluation of data preprocessing software tools to increase efficiency and accuracy in diffusion kurtosis imaging

The starry sky liver: multiple biliary hamartomas on MR cholangiopancreatography

The starry sky liver: multiple biliary hamartomas on MR cholangiopancreatography

ML-Based Radiomics Analysis for Breast Cancer Classification in DCE-MRI

Breast cancer is the most common malignancy that threatening women’s health. Although Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) for breast lesions characterization is widely used in the clinical practice, physician grading performance is still not optimal, showing a specificity of about 72%. In this work Radiomics was used to analyze a dataset acquired with two different protocols in order to train Machine-Learning algorithms for breast cancer classification. Original radiomic features were expanded considering Laplacian of Gaussian filtering and Wavelet Transform images to evaluate whether they can improve predictive performance. A Multi-Instant features selection invo…

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 …

Diagnostic performance of qualitative and radiomics approach to parotid gland tumors: which is the added benefit of texture analysis?

Objective: To investigate whether MRI-based texture analysis improves diagnostic performance for the diagnosis of parotid gland tumors compared to conventional radiological approach. Methods: Patients with parotid gland tumors who underwent salivary glands MRI between 2008 and 2019 were retrospectively selected. MRI analysis included a qualitative assessment by two radiologists (one of which subspecialized on head and neck imaging), and texture analysis on various sequences. Diagnostic performances including sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of qualitative features, radiologists’ diagnosis, and radiomic models were evaluated. Result…

Whole-body MRI in patients with lymphoma: collateral findings

Whole body MRI (WB-MRI) is a non invasive technique increasingly used to stage (1-4) and follow-up (5-8) patients with malignancies such as lymphoproliferative disorders. It is now recognized as a promising tool that provides high quality anatomical imaging and a multiparametric approach of the ent

A mistaken case of non-q wave acute infarction

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

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

Role of high-resolution ultrasound in guiding treatment of idiopathic plantar fasciitis with minimally invasive techiniques

The aim of this study was to assess the reliability of peri-fascial oedema as a sonographic criterion for selecting the most appropriate treatment (ultrasound-guided corticosteroid injection or ultrasound-guided extracorporeal shock wave therapy) of idiopathic plantar fasciitis (IPF).Sixty-four patients with a clinical diagnosis of unilateral refractory IPF, treated conservatively for at least 8 weeks, were studied with high-resolution ultrasound (HRUS). Pain intensity was evaluated with a visual analogue scale (VAS). HRUS was used to confirm IPF and identify the presence of peri-fascial oedema. Patients with an HRUS diagnosis of IPF were grouped according to the presence (A) or absence (B)…

DIAGNOSTIC ACCURACY OF MDCT 40 SLICES IN PATIENTS WITH CHEST PAIN

Brain damage in hanging: A new CT finding

We report a 23-year-old man who attempted suicide by hanging. There have been few reports of involvement of the brain parenchyma shown on CT, all showing ischaemic lesions. This is the first report of multifocal intracerebral haematomas due to hanging seen on CT.

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

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

Cardiovascular magnetic resonance characterization of a hamartoma in an asymptomatic child

CHIRURGIA NON INVASIVA AD ULTRASUONI FOCALIZZATI RM GUIDATI (MRGFUS) PER IL TRATTAMENTO DEI FIBROMI UTERINI SINTOMATICI: NOSTRA ESPERIENZA SULL'ELEGGIBILITÀ DELLE PAZIENTI

Evaluation of lateral ankle instability with weight-bearing MRI. Preliminary Experience

PURPOSE/INTRODUCTION: To assess the usefulness of weight-bearing examination of the ankle performed with a dedicated MRI scanner in the evaluation of patients with clinical evidence of lateral ankle instability. MATERIALS AND METHODS: We retrospectively evaluated ankle MR examinations of 18 patients, performed between September 2008 and January 2009. Spin echo T1W, Turbo Spine Echo T2W, 3D Steady-State (SSE) and Short Tau Inversion Recovery (STIR) images were acquired with a 0.2 T scanner (G-Scan, Esaote Spa, Genoa, Italy) in both weight-bearing position and normal conventional supine position. A dedicated extremities receiver coil was used. If present, signs of instability and ligament sig…

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

PRESENTAZIONE DI UN CASO DI MENINGOCELE SACRALE ANTERIORE: CARATTERISTICHE NEURORADIOLOGICHE E DIAGNOSI DIFFERENZIALE

SCOPO DEL LAVORO: Lo scopo di questo lavoro è documentare un caso di meningocele sacrale anteriore (Anterior Sacral Meningocele, ASM) rara forma di disrafismo spinale, diagnosticato in una giovane di 13 anni con riscontro ecografico di formazione cistica di verosimile pertinenza annessiale dopo visita Specialistica Ginecologica. La paziente si presenta con una clinica caratterizzata da: dolore pelvico, costipazione e cistiti ricorrenti. Sarà inoltre fatto un breve excursus sulle possibili diagnosi differenziali con altre masse pelviche a sviluppo presacrale. MATERIALI E METODI: A seguito di consulenza ginecologica, la paziente è stata sottoposta ad una ecografia transaddominale, che ha e…

Hippocampal and Amygdalar Volumes Changes in Drug Addicts: A Preliminary Study

Oral comunication for American Society of Neuroradiology 45th Annual Meeting. Chicago, June 9-14 2007

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

18F-Florbetaben PET/CT to Assess Alzheimer's Disease: A new Analysis Method for Regional Amyloid Quantification.

Background and purpose While AD can be definitively confirmed by postmortem histopathologic examination, in vivo imaging may improve the clinician's ability to identify AD at the earliest stage. The aim of the study was to test the performance of amyloid PET using new processing imaging algorithm for more precise diagnosis of AD. Methods Amyloid PET results using a new processing imaging algorithm (MRI-Less and AAL Atlas) were correlated with clinical, cognitive status, CSF analysis, and other imaging. The regional SUVR using the white matter of cerebellum as reference region and scores from clinical and cognitive tests were used to create ROC curves. Leave-one-out cross-validation was carr…

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

Spectrum of collateral findings in multislice CT coronary angiography.

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

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

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

IMPACT OF RADIATION DOSE AND PROTECTION IN THE ITALIAN PAEDIATRIC RADIOLOGICAL LITERATURE

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

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…

MDCT-CA VERSUS MYOCARDIAL SCINTIGRAPHY TO DETECT SIGNIFICANT CORONARY ARTERY DISEASE

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

Chirurgia trans-cranica mediante ultrasuoni focalizzati ad alta intensità su guida RM (trans-cranial MRI-guided Focused Ultrasound Surgery, tcMRgFUS): esperienza preliminare a 1,5T

Scopo del Lavoro Presentiamo i risultati preliminari ottenuti con la prima istallazione italiana di un’apparecchiatura tcMRgFUS (prima ed unica apparecchiatura al mondo installata su uno scanner RM da 1,5T) per trattamenti di neurochirurgia funzionale in pazienti con tremore essenziale, Parkinson idiopatico unilaterale prevalentemente tremorigeno e dolore neuropatico. Materiali e Metodi Sono stati arruolati pazienti con disordini neurologici resistenti a terapia medica. I pazienti eleggibili sono stati sottoposti ad esame TC ed RM di screening per escludere controindicazioni al trattamento. I trattamenti tcMRgFUS sono stati eseguiti da un gruppo multidisciplinare ottimizzando i parametri di…

Italian multicenter, prospective study to evaluate the negative predictive value of 16- and 64-slice MDCT imaging in patients scheduled for coronary angiography (NIMISCAD-Non Invasive Multicenter Italian Study for Coronary Artery Disease)

This was a prospective, multicenter study designed to evaluate the utility of MDCT in the diagnosis of coronary artery disease (CAD) in patients scheduled for elective coronary angiography (CA) using different MDCT systems from different manufacturers. Twenty national sites prospectively enrolled 367 patients between July 2004 and June 2006. Computed tomography (CT) was performed using a standardized/optimized scan protocol for each type of MDCT system (> or =16 slices) and compared with quantitative CA performed within 2 weeks of MDCT. A total of 284 patients (81%) were studied by 16-slice MDCT systems, while 66 patients (19%) by 64-slice MDCT scanners. The primary analysis was on-site/off…

Imaging for Ballistic Trauma: Other Applications of Forensic Imaging in the Living

Firearms are mechanical instruments that allow launching remote specific bodies with mass (bullets) exploiting burst gas energy. The role of imaging for ballistic trauma is crucial in order to define the main characteristics for both judiciary and nonjudiciary purpose, which are the intracorporeal trajectory, the entrance and exit wounds, and the general characteristics of gunshot injuries.

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

Ottimizzazione dell’enhancement vascolare

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). …

Imaging appearance of treated hepatocellular carcinoma

Surgical resection and imaging guided treatments play a crucial role in the management of hepatocellular carcinoma (HCC). Although the primary end point of treatment of HCC is survival, radiological response could be a surrogate end point of survival, and has a key role in HCC decision-making process. However, radiological assessment of HCC treatment efficacy is often controversial. There are few doubts on the evaluation of surgical resection; in fact, all known tumor sites should be removed. However, an unenhancing partial linear peripheral halo, in most cases, surrounding a fluid collection reducing in size during follow-up is demonstrated in successfully resected tumor with bipolar radio…

RUOLO DELL’ANGIOGRAFIA CORONARICA IN TOMOGRAFIA

Evaluation of post-treatment response of epatocellular carcinoma: comparison of ultrasonography with second generation ultrasound contrast agent and dynamic CT.

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

0263: Percutaneous US-Guided Hematoma Aspiration to Reduce Recovery Time of II Grade Muscle Strain in Elite Soccer Players

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

Magnetic resonance imaging of the pituitary gland in patients with secondary hypogonadism due to transfusional hemochromatosis

To identify pituitary iron overload in patients with transfusional hemochromatosis causing secondary hypogonadism, we prospectively evaluated signal intensity abnormalities of the anterior lobe of the pituitary gland of 18 patients affected by transfusion-dependent thalassemia major and secondary hypogonadism. Magnetic resonance (MR) imaging is useful to assess pituitary iron overload in patients with transfusional hemochromatosis and secondary hypogonadism by detection of a significant decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2*-weighted images. The decreased signal intensity of the anterior lobe of the pituitary gland on GRE T2*-weighted images was co…

Higher intracoronary attenuation improves diagnostic accuracy in MDCT coronary angiography

OBJECTIVE: The purpose of this study was to investigate whether the amount of intracoronary attenuation influences the diagnostic accuracy of MDCT coronary angiography in the detection of clinically significant stenosis. MATERIALS AND METHODS: One hundred twenty patients in sinus rhythm with suspected coronary artery disease who underwent MDCT of the heart and conventional coronary angiography were retrospectively selected. The population was divided into two groups depending on median (326 H) coronary vascular enhancement (i.e., low attenuation and high attenuation). The diagnostic accuracy of MDCT for the detection of clinically significant coronary artery lesions (> or = 50% lumen reduct…

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

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

Dysphagia and dysphonia in patients with thyroid goiter before and after thyroidectomy: Possibly related to the pharyngo-esophageal reflux laryngitis? Videofluorographic evaluation

Dysphagia and dysphonia in patients with thyroid goiter before and after thyroidectomy: Possibly related to the pharyngo-esophageal reflux laryngitis? Videofluorographic evaluation

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

Gozzo semplice e nodulare

Influence of intracoronary attenuation on coronary plaque measurements using multislice computed tomogarphy : observation in an ex vivo model of coronary computed tomography angiography

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

Whole-body MRI radiomics model to predict relapsed/refractory Hodgkin Lymphoma: A preliminary study.

Purpose A strong prognostic score that enables a stratification of newly diagnosed Hodgkin Lymphoma (HL) to identify patients at high risk of refractory/relapsed disease is still needed. Our aim was to investigate the potential value of a radiomics analysis pipeline from whole-body MRI (WB-MRI) exams for clinical outcome prediction in patients with Hodgkin Lymphoma (HL). Materials and methods Index lesions from baseline WB-MRIs of 40 patients (22 females; mean age 31.7 ± 11.4 years) with newly diagnosed HL treated by ABVD chemotherapy regimen were manually segmented on T1-weighted, STIR, and DWI images for texture analysis feature extraction. A machine learning approach based on the Extra T…

CT enterography as a powerful tool for the evaluation of inflammatory activity in Crohn’s disease: relationship of CT findings with CDAI and acute-phase reactants

Few studies have correlated computed tomography enterography (CTE) findings with Crohn’s disease (CD) clinical and biochemical activity. The aim of this study was to evaluate correlations between CTE findings with CD activity. The CTE datasets from 62 patients were retrospectively reviewed for different parameters: bowel wall thickening and hyperenhancement, mesenteric alterations, abdominal free fluid and complications related to the disease (fistulas, strictures, abscesses). Activity was assessed using the Crohn’s Disease Activity Index (CDAI) and some biochemical markers (C-reactive protein, erythrocyte sedimentation rate, alpha 2-globulins, fibrinogen, platelets, haemoglobin). Correlati…

Digital cineradiographic study of swallowing in patients with amyotrophic lateral sclerosis

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

Evolution of indeterminate hepatocellular nodules at Gd-EOB-DPTA-enhanced MRI in cirrhotic patients

To retrospectively analyze the evolution of indeterminate hepatocellular nodules in cirrhotic patients on serial Gd-EOB-DPTA-enhanced MRI, and to identify predictors of HCC development. This IRB approved study included 33 cirrhotic patients with 69 indeterminate hepatocellular nodules (mean diameter 1.1 cm) at baseline Gd-EOB-DPTA-enhanced MRI and a Gd-EOB-DPTA-enhanced-MRI follow-up of at least 2 years. Two radiologists evaluated size and signal intensity of each nodule at baseline and follow-up. Age, cirrhosis etiology, and HCC history were recorded. Data were compared between nodules that became HCCs at follow-up (HCC) and those that did not (no-HCC). On follow-up, 5/69 nodules became HC…

Transcranial magnetic resonance-guided focused ultrasound thalamotomy as a safe treatment option in multiple sclerosis patients with essential tremor

Transcranial magnetic resonance-guided focused ultrasound is a recently introduced incisionless treating option for essential tremor and tremor-dominant idiopathic Parkinson disease. There is preliminary evidence that it may result in a promising effective treatment option for other movement disorders too. Here, we report on two patients with multiple sclerosis with medication refractory debilitating essential tremor comorbidity who successfully underwent unilateral Vim tcMRgFUS thalamotomy for tremor control. Patients' clinical condition and expanded disability status scale scores showed no changes during the 1-year follow-up period with no evidence of multiple sclerosis activity or progre…

Lithiasis and Spontaneous Hemobilia

Learning objectives Background Findings and procedure details Conclusion Personal information References

Unusual case of left ventricular pseudoaneurysm.

A 71 year-old man with a history of previous anterior myocardial infarction, triple coronary artery bypass graft and left ventricular (LV) aneurysmectomy was admitted to the cardiology unit for chest pain. Physical examination showed a pulsing mass in the left chest wall. Cardiac multislice computed tomography showed a rare case of LV pseudoaneurysm (6.3 x 6 x 10 cm) communicating by a fistulous trait (1 cm) with the left anterior chest wall (C7-C8), creating a subfascial mass (7.1 x 3.6 cm).

Seeding after radiofrequency ablation of hepatocellular carcinoma in patients with cirrhosis: a prospective study.

Abstract Background Neoplastic seeding of hepatocellular carcinoma may arise after radiofrequency ablation. Aims In order to clarify the real risk of seeding, we observed a prospective cohort of patients undergoing radiofrequency ablation. Methods Ninety-three (22.9%) out of 406 consecutive patients with hepatocellular carcinoma superimposed to cirrhosis diagnosed at our Liver Unit (2000–2005) were selected for radiofrequency ablation according to the Barcelona 2000 EASL guidelines. Seventy-one patients were treated by a percutaneous approach and 22 at laparotomy. After radiofrequency ablation ultrasound scan was repeated every 3 months and spiral-computed tomography every 6 months. Results…

Airway distensibility by HRCT decreases with severity of COPD.

CT coronary angiography at an ultra-low radiation dose (< 0.1 mSv): feasible and viable in times of constraint on healthcare costs

Computed tomography coronary angiography (CTCA) has reached very high standards both in terms of diagnostic performance and radiation dose reduction. This commentary follows a report on CTCA using less than 0.1 mSv in selected patients. This is an extraordinary accomplishment, both for technology and for medicine. The difficult task is now to implement this tool in clinical practice so it can play the best possible role. CTCA can improve diagnostic pathways, can save money for healthcare systems and could even improve pharmacological therapy. All of this may happen, but it will require the combined effort of all the experienced operators in this field, including the referring clinicians. In…

Sequenze di diffusione (DWI) nello studio del carcinoma prostatico: confronto tra b700 e b1400. Nostra esperienza

Materiali e metodi: e' stato analizzato retrospettivamente un campione di 24 pazienti nei quali è stato posto il sospetto RM di CaP confermato all'esame istologico in 20 pazienti. Questi, di età compresa tra 47 e 76 anni (media 64+/- 10), hanno costituito la nostra popolazione. L'esame RM è stato eseguito con un'apparecchiatura da 1.5 T mediante l'ausilio di bobina endorettale. Oltre al protocollo (T2, T1), la valutazione spettroscopica e dinamica postcontrastografica sono state acquisite sequenze DWI sul piano assiale con valori di b pari a 700 e 1400 s/mm2. Le immagini morfologiche e di diffusione sono state analizzate da due radiologi in consenso. E' stato calcolato il coefficiente di di…

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

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

Magnetic resonance in the assessment of myocardial perfusion: A reliable alternative to myocardial scintigraphy?

coronary-artery disease

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

5th International Symposium on Focused Ultrasound

Introduction Breast fibroadenomata (FAD) are benign lesions which occur in about 10 % of all women. Diagnosis is made by triple assessment (physical examination, imaging and/or histopathology/cytology). For a definitive diagnosis of FAD, the treatment is conservative unless the patient is symptomatic. For symptomatic patients, the lumps can be surgically excised or removed interventionally by vacuum-assisted mammotomy (VAM). Ablative techniques like high-intensity focused ultrasound (HIFU), cryo-ablation and laser ablation have also been used for the treatment of FAD, providing a minimally invasive treatment without scarring or poor cosmesis. This review summarises current trials using mini…

Lacrimal gland herniation in Graves ophthalmopathy: a simple and useful MRI biomarker of disease activity

Lacrimal gland (LG) involvement in patients with Graves ophthalmopathy (GO) has been considered as a potential cause of the associated GO symptoms and different studies demonstrated the LG involvement in patients with GO than healthy controls. The aim of this study was to evaluate LG involvement, through measurement of its herniation, using a magnetic resonance imaging (MRI) index, in patients with different GO activities. Thirty-two consecutive Caucasian patients affected by GO were enrolled and grouped in group A (16 with inactive GO, CAS < 3) and B (16 with active GO, CAS ≥ 3) according to their GO activity. All patients underwent clinical-endocrinological assessment, a complete ocular e…

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

Trans-cranial MRI-guided Focused Ultrasound Surgery (tcMRgFUS): preliminary Italian (and world-first) experience at 1,5 Tesla (first 5 patient treated)

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

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

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

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

Learning objectives Background Findings and procedure details Conclusion Personal information References

Thromboembolic complications of COVID-19: the combined effect of a pro-coagulant pattern and an endothelial thrombo-inflammatory syndrome.

Coronavirus disease 2019 (COVID-19) is a newly emerging human infectious disease that has quickly become a worldwide threat to health, mainly causing severe acute respiratory syndrome. In addition to the widely described respiratory syndrome, COVID-19 may cause life-treating complications directly or indirectly related to this infection. Among these, thrombotic complications have emerged as an important issue in patients with COVID-19 infection, particularly in patients in intensive care units. Thrombotic complications due to COVID-19 are likely to occur due to a pro-coagulant pattern encountered in some of these patients or to a progressive endothelial thrombo-inflammatory syndrome causing…

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

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

The “central dot sign” in acute epiploic appendagitis

Epiploic appendagitis is the acute inflammation and infarction of epiploic appendages, commonly secondary to torsion. It is a great mimicker as its clinical manifestation may be similar to appendicitis, diverticulitis, or colitis. Focal abdominal pain, tenderness, and mild pyrexia are clinical features of the condition [1]. Epiploic appendages are pedunculated adipose structures which extend from the serosal surface of the colon, along the free taenia and taenia omentalis. They are abundant in the caecum and sigmoid colon and absent in the rectum

Focal lesions of the Achilles tendon: real-time variation of lesion grading during ultrasound-guided platelet-concentrate injection.

INTRODUCTION: Achillodynia (Achilles tendon pain) is a significant source of disability for many sport people. Achilles tendon (AT) tear is the third most frequent major tendon disruption after those of the rotator cuff and knee extensor mechanism. The incidence of the AT tears is 11–18% overall. Unlike acute AT tear, chronic tear diagnosis is more difficult to make particularly when the chronic tear involves the AT only partially. Over the last 10 years, real time ultrasound has been used increasingly to diagnose Achilles tendon tears, thanks to its ability to perform dynamic study, in passive and active muscle contraction. Furthermore, ultrasound-guided procedures are increasingly used fo…

Ultrasound guided intra-articular injection of hyalan g-f 20 in the tratment of symptomatic hip osteoarthritis

role of the high resolution ultrasonography to andress the tratment of idiopatic plantar fascitisi with mini - invasive techniques

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

CT and MR imaging of the inflammatory diseases

EMORRAGIA IN TUMOR DA NEURINOMA DELL’VIII N.C. & SIMDROMI PARALITICHE ANTERIORE E POSTERIORE IMPROVVISA: SEMEIOTICA RADIOLOGICA

Gli autori riportano un raro caso clinico di una paziente di 77 anni che giunge alla nostra osservazione in regime di urgenza per vertigine improvvisa associata a nausea e vomito, stato confusionale, atassia, paralisi completa del VI nervo cranico di destra con strabismo convergente, segni di sofferenza del IX, X ed XI nervo cranico omolaterali all’abducente e iniziale comparsa di segni statici e dinamici di paralisi periferica del VII nervo cranico di destra. L’insorgenza improvvisa di Sindromi paralitiche associate, anteriori e posteriori, ha indirizzato verso il sospetto di lesione occupante spazio a sede in fossa cranica posteriore/tronco encefalo richiedendo pertanto l’ausilio della di…

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

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

Visceral Adiposity Index

OBJECTIVE To individuate a novel sex-specific index, based on waist circumference, BMI, triglycerides, and HDL cholesterol, indirectly expressing visceral fat function. RESEARCH DESIGN AND METHODS Visceral adiposity index (VAI) was first modeled on 315 nonobese healthy subjects. Using two multiple logistic regression models, VAI was retrospectively validated in 1,498 primary care patients in comparison to classical cardio- and cerebrovascular risk factors. RESULTS All components of metabolic syndrome increased significantly across VAI quintiles. VAI was independently associated with both cardiovascular (odd ratio [OR] 2.45; 95% CI 1.52–3.95; P &amp;lt; 0.001) and cerebrovascular (1.63; 1.0…

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

DESCRIZIONE DI UN CASO DI LESIONE REVERSIBILE DELLO SPLENIO DEL CORPO CALLOSO IN PAZIENTE CON MONONUCLEOSI INFETTIVA DA COINFEZIONE EPSTEIN-BARR VIRUS (EBV) E CITOMEGALOVIRUS (CMV)

SCOPO Presentiamo un caso di encefalite virale con lesione reversibile dello splenio del corpo calloso (SCC) in un ragazzo di 16 anni con mononucleosi infettiva da coinfezione Epstein-Barr Virus (EBV) e Citomegalovirus (CMV). MATERIALI E METODI Il paziente, a causa della comparsa improvvisa di stato confusionale, irrigidimento e movimenti involontari alternati a tremori in corso di mononucleosi infettiva, giungeva in PS, dove eseguiva una TC encefalo (Siemens SOMATOM Definition AS+ - 128 strati) in condizioni di base ed in tecnica sequenziale, che non evidenziava reperti significativi. Veniva quindi ricoverato con il sospetto di encefalite virale e, il giorno successivo, veniva sottoposto a…

Cumulative doses analysis in young trauma patients: a single-centre experience

Multidetector computed tomography (MDCT) represents the main source of radiation expo- sure in trauma patients. The radiation exposure of young patients is a matter of considerable medical concern due to possible long-term effects. Multiple MDCT stud- ies have been observed in the young trauma population with an increase in radiation exposure. We have identi- fied 249 young adult patients (178 men and 71 women; age range 14-40 years) who had received more than one MDCT study between June 2010 and June 2014. According to the International Commission on Radio- logical Protection publication, we have calculated the cumulative organ dose tissue-weighting factors by using CT-EXPO software ® . We…

SEMI-AUTOMATIC VOLUMETRIC SEGMENTATION OF THE UPPER AIRWAYS IN PATIENTS WITH PIERRE ROBIN SEQUENCE

Pierre Robin malformation is a rare craniofacial dysmorphism whose pathogenesis is multifactorial. Although there is some agreement in non-invasive treatment in less severe cases, the dispute is still open on cases with severe respiratory impairment. We present a semi-automatic novel diagnostic tool for calculating upper airway volume, in order to eventually address surgery in patients with Pierre Robin Sequence (PRS). Multidetector CT datasets of two patients and two controls were tested to assess the proposed method for ROI segmentation, upper airway volume computation and three-dimensional reconstructions. The experimental results show an irregular pattern and a severely reduced cross-s…

Gadoxetate disodium-enhanced magnetic resonance cholangiography for the noninvasive detection of an active bile duct leak after laparoscopic cholecystectomy.

Abstract We report a case of an endoscopically confirmed biliary leak of the common hepatic duct after laparoscopic cholecystectomy that was prospectively diagnosed on gadoxetate disodium-enhanced magnetic resonance cholangiography. Whereas dynamic contrast-enhanced magnetic resonance images during the early vascular phases helped to rule out the causes of possible complications such as seroma, hematoma, or abdominal abscess, delayed hepatobiliary phase imaging was crucial for unequivocal diagnosis and location of the biliary leak. The diagnosis prompted therapeutic endoscopic retrograde cholangiography whereby a polytetrafluoroethylene-covered nitinol stent graft was successfully placed to…

Imaging Approach for Evaluation of Focal Liver Lesions

Focal liver lesions are common in the general population. Radiology (imaging) plays a pivotal role for the diagnosis, staging, treatment planning, and follow-up of focal liver lesions. To maximize lesion detection and characterization, imaging needs to be performed with appropriate equipment by using protocols carefully designed on the basis of the underlying clinical context. In addition, the decision of an imaging modality cannot be based on the diagnostic accuracy of an imaging test solely but must also consider patient safety and cost-effectiveness.

[Detection of extra-articular soft-tissue involvement in rheumatoid arthritis: value of color-coded Doppler sonography]

Approccio diagnostico non invasivo con tomografia computerizzata multidetettore a 40 strati per lo studio della malattia aterosclerotica coronarica

Background. Multidetector computed tomography coronary angiography (MDCT-CA) is a non-invasive technique that clearly shows coronary anatomy and correctly identifies plaque location and morphology. In this study we assessed diagnostic accuracy of MDCT-CA in detectiong significant stenosis in patients with clinically relevant coronary tree disease. Methods. Fifty patients (38 males, 12 females, mean age 60.9 ± 9.2 years) with atypical chest pain, stable or unstable angina pectoris, or non-ST-elevation myocardial infarction underwent MDCT-CA (Brilliance 40, Philips Medical Systems, Cleveland, OH, USA) within 3 days before diagnostic conventional coronary angiography. Inclusion criteria were s…

Imaging evaluation of cardiac stem cells transplantation

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

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

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

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

Visceral Adiposity Index (VAI): A Reliable Indicator Of Visceral Fat Function Associated With Cardiometabolic Risk.

Objective: To individuate a novel sex-specific index, based on Waist Circumference (WC), Body Mass Index (BMI), Triglycerides (TG) and HDL cholesterol (HDL), indirectly expressing visceral fat function. Research design and Methods: Visceral Adiposity Index (VAI) was first modelled on 315 non-obese healthy subjects. Using two multiple logistic regression models, VAI was retrospectively validated in 1,498 primary care patients in comparison to classical cardio and cerebrovascular risk factors. Results: All components of metabolic syndrome increased significantly across VAI quintiles. VAI was independently associated with both cardiovascular (OR:2.45; 95%CI: 1.52-3.95; p&lt;0.001) and cerebrov…

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…

Infarct characterization using CT

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

Survival of patients with hepatocellular carcinoma (HCC) treated by percutaneous radio-frequency ablation (RFA) is affected by complete radiological response.

Background: Radio-frequency ablation (RFA) has been employed in the treatment of Barcelona Clinic Liver Cancer (BCLC) early stage hepatocellular carcinoma (HCC) as curative treatments. Aim: To assess the effectiveness and the safety of RFA in patients with early HCC and compensated cirrhosis. Methods: A cohort of 151 consecutive patients with early stage HCC (122 Child-Pugh class A and 29 class B patients) treated with RFA were enrolled. Clinical, laboratory and radiological follow-up data were collected from the time of first RFA. A single lesion was observed in 113/151 (74.8%), two lesions in 32/151 (21.2%), and three lesions in 6/151 (4%) of patients. Results: The overall survival rates …

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

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…

EMANGIOPERICITOMA INTRACRANICO PRESENTAZIONE DI UN CASO E REVISIONE DELLA LETTERATURA

SCOPO DEL LAVORO Presentiamo a un caso di emangiopericitoma (HPC) in un paziente emicranico (maschio, 49 enne) che giunge alla nostra attenzione per l’insorgenza di confusione mentale e emisindrome sentitivo-motoria destra. Saranno inoltre riportati alcuni cenni sulla classificazione internazionale di questo raro tumore mesenchimale riccamente vascolarizzato, non tralasciando le possibili diagnosi differenziali con altri più comuni espansi di pertinenza extra- assiale. MATERIALI E METODI Dopo una prima valutazione in PS il paziente è stato sottoposto a esame TC encefalo e trasferito nel reparto di neurochirurgia. Successivamente ad un esame RM encefalo con sequenze morfologiche convenzion…

Patients perception of ionising radiation risks in CT ionising exposure. Does dose bill works?

Communicating to patients the magnitude of risk related to ionizing radiation exposure is problematic because of the uncertainty in estimates derived principally from epidemiological studies of large populations [1-6]. Euratom directive 59/2013 requires that dose bill will be part of the radiological report in European Countries [7]. However, how a risk is framed has a profound effect on risk perception. To date, no previous studies evaluated which could be the best way to make patient friendly dose bill. Our aim was to evaluate patients' perception of radiation exposure related to routine CT and their understanding after dose bill.

MR imaging of pancreatic changes in patients with transfusion-dependent beta-thalassemia major.

The aim of this study was to evaluate MR imaging changes of the pancreas in patients with transfusion-dependent beta-thalassemia major.Twenty patients with transfusion-dependent beta-thalassemia major were examined using MR imaging at 0.5 T, with spin-echo T1-weighted, fast spin-echo T2-weighted, and gradient-echo T2*-weighted sequences. Image analysis was performed to assess pancreas-to-fat signal intensity ratios for all pulse sequences. Pancreatic exocrine and endocrine function and serum ferritin levels were assessed. Twenty healthy volunteers underwent MR imaging with the same three sequences and served as a control group.The pancreas-to-fat signal intensity ratio was significantly dec…

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

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

CT angiography for the assessment of EVAR complications : a pictorial review

Aortic aneurysm; Blood vessel prosthesis implantation; Endovascular procedures Aneurisma aórtico; Implantación de prótesis de vasos sanguíneos; Procedimientos endovasculares Aneurisma aòrtic; Implantació de pròtesis de vasos sanguinis; Procediments endovasculars Endovascular aneurysm repair (EVAR) is a minimally invasive treatment proposed as an alternative to open repair in patients with abdominal aortic aneurysms. EVAR consists in a stent-graft placement within the aorta in order to exclude the aneurysm from arterial circulation and reduce the risk of rupture. Knowledge of the various types of devices is mandatory because some stents/grafts are more frequently associated with complication…

Imaging features of adrenal masses

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

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

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

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

Long-term evolution of LI-RADS observations in HCV-related cirrhosis treated with direct-acting antivirals.

Background &amp; Aims The risk of progression of indeterminate observations to hepatocellular carcinoma (HCC) after direct-acting antivirals (DAA) is still undetermined. To assess whether DAA therapy changes the risk of progression of observations with low (LR-2), intermediate (LR-3) and high (LR-4) probability for HCC in cirrhotic patients and to identify predictors of progression. Methods This retrospective study included cirrhotic patients treated with DAA who achieved sustained virological response between 2015 and 2019. A total of 68 patients had pre-DAA indeterminate observations and at least six months CT/MRI follow-up before and after DAA. Two radiologists reviewed CT/MRI studies to…

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…

Accuracy of SWI sequences compared to T2*-weighted gradient echo sequences in the detection of cerebral cavernous malformations in the familial form

Purpose The purpose of this study was to assess the accuracy of susceptibility-weighted imaging (SWI), compared with T2*-weighted gradient echo (GRE) imaging in assessing cerebral cavernous malformations. Materials and methods We retrospectively evaluated 21 patients with a familial form of cavernous malformation. Magnetic resonance (MR) protocol included non-enhanced and contrast-enhanced fast-spin echo (FSE) T1-weighted sequences, FSE T2-weighted sequences, fluid-attenuated inversion-recovery (FLAIR), GRE T2*-weighted and SWI sequences. Images were reviewed in consensus by two expert neuroradiologists to assess the location, number, size and conspicuity of the lesions on T2*-weighted GRE …

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.

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

Hepatocellular carcinoma enhancement on contrast-enhanced CT and MR imaging: response assessment after treatment with sorafenib: preliminary results

PURPOSE: This study was undertaken to compare response evaluation criteria in solid tumours (RECIST) 1.1 and modified RECIST (mRECIST) in patients with unresectable hepatocellular carcinoma (HCC) on sorafenib, and to describe HCC enhancement changes before and after sorafenib treatment. METHODS AND MATERIALS: Seventeen patients (12 men, 5 women; mean age 69 years; age range 58-79 years) were included. Tumour response was assessed according to RECIST and mRECIST. Two readers placed a region of interest (ROI) within each target lesion, on the portion showing enhancement during the arterial phase. The lesion attenuation values measured within the ROIs on computed tomography or the signal inten…

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…

Imaging ecografico del cordone ombelicale umano.

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…

The added diagnostic value of 64-row multidetector CT combined with contrast-enhanced US in the evaluation of hepatocellular nodule vascularity: implications in the diagnosis of malignancy in patients with liver cirrhosis.

The aim of this study was to assess the added diagnostic value of contrast-enhanced US (CEUS) combined with 64-row multidetector CT (CT) in the assessment of hepatocellular nodule vascularity in patients with liver cirrhosis. One hundred and six cirrhotic patients (68 male, 38 female; mean age +/- SD, 70 +/- 7 years) with 121 biopsy-proven hepatocellular nodules (72 hepatocellular carcinomas, 10 dysplastic and 15 regenerative nodules, 12 hemangiomas, and 12 other benignancies) detected during US surveillance were prospectively recruited. Each nodule was scanned by CEUS during the arterial (10-40 s), portal venous (45-90 s), and delayed sinusoidal phase (from 100 s after microbubble injectio…

Images - Computed tomography urographic appearance of traumatic rupture of renal cyst into the pyelocaliceal system.

Spontaneous or traumatic rupture of renal cysts, documented by radiological imaging, occurs infrequently. The pathogenesis of a cyst rupture is still unclear, except when it has occurred following trauma or when the cyst has become infected. Imaging plays a crucial role in the diagnosis, management, surveillance, and choice of lesions that need treatment.

Anal Fistula in Crohn’s Disease

Transmural bowel inflammation in Crohn’s disease (CD) is associated with the development of fistulas, which are tracts or communications that connect two epithelial-lined organs. Common sites for fistulas connect the intestine to bladder (enterovesical), to skin (enterocutaneous), to bowel (enteroenteric), and to the vagina (enterovaginal).

Restoring Neurological Physiology: The Innovative Role of High-Energy MR-Guided Focused Ultrasound (HIMRgFUS). Preliminary Data from a New Method of Lesioning Surgery

Background Tremor is a disabling condition, common to several neurodegenerative diseases. Lesioning procedures and deep brain stimulation, respectively, of the ventralis intermedius nucleus for intentional tremor, and of the subthalamic nucleus for parkinsonian resting tremor, have been introduced in clinical practice for patients refractory to medical treatment. The combination of high-energy focused ultra-sound (HIFUS) with sophisticated magnetic resonance (MR) instrumentation, together with accurate knowledge of the stereotactic brain coordinates, represents a revolution in neuromodulation. Methods At the Neurosurgical Clinic and the Radiology Department of the University of Palermo,, tw…

Re: Small solid renal masses: characterization by diffusion-weighted MRI at 3 T. A reply.

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

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

High Iodine Concentration Contrast Material for Noninvasive Multislice Computed Tomography Coronary Angiography

OBJECTIVE: The objective of this study was to compare intracoronary attenuation on 16-row multislice computed tomography (16-MSCT) coronary angiography using 2 contrast materials (CM) with high iodine concentration. MATERIAL AND METHODS: Forty consecutive patients (29 male, 11 female; mean age, 61 ± 11 years) with suspected coronary artery disease were randomized to 2 groups to receive 100 mL of either iopromide 370 (group 1: Ultravist 370, 370 mg iodine/mL; Schering AG, Berlin, Germany) or iomeprol 400 (group 2: Iomeron 400, 400 mg iodine/mL; Bracco Imaging SpA, Milan, Italy). Both CM were administered at a rate of 4 mL/s. All patients underwent 16-MSCT coronary angiography (Sensation 16; …

Spring ligament chronic injury on MR imaging

Intraindividual comparison of hepatic venous phase and delayed phase for the detection of washout contrast-enhancement pattern of HCC on MDCT of the liver.

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

Imaging ecografico del cordone ombelicale umano Ecographic imaging of the human umbilical cord

Postmortem Imaging in Drowning

The diagnosis of drowning is one of the most difficult in the field of forensic medicine since the autopsy findings are often not specific and the laboratory examinations are controversially appreciated by the scientific community. In a cadaver recovered from water, it is of utmost importance to differentiate antemortem and postmortem drowning. This chapter fully investigates biological/thanato-chemical, pathological and imaging findings which may guide the definitive diagnosis.

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.…

Congenital Cystic Lesions of the Bile Ducts: Imaging-Based Diagnosis

Congenital cystic lesions of the bile ducts represent a spectrum of liver and biliary system lesions, resulting from abnormal embryologic development of the ductal plate. These disorders include Caroli disease, choledochal cysts, autosomal dominant polycystic liver disease, congenital hepatic fibrosis, and biliary hamartomas. Each disorder carries a peculiar clinical presentation, prognosis, and risk of complications. Knowledge of radiological findings of fibropolycystic liver diseases is crucial for their appropriate detection and for differential diagnosis with other similar hepatic cystic lesions, in order to avoid relevant misdiagnosis. The aim of this review is to provide an illustrati…

Valutazione mediante hrct delle specifiche alterazioni polmonari nelle diverse forme cliniche di sclerosi sistemica

MRI evaluation of spine abnormalities in the supine position and under physiological load in athletes with a dedicated MR scanner

Purpose of our study was to evaluate the behavior of the lumbar spine of young athletes in the supine and standing position, taking into account all postural changes that the spine undergoes during physiological load, any alterations and any discrepancies in the detection of pathology between the two positions. Between August 2008 and October 2009, we evaluated 40 sportsman (20 men and 20 women) with symptoms of lumbar pain. All subjects underwent MRI with a dedicated scanner of 0.25 Tesla (G-Scan, Esaote Biomedica, Genoa, Italy) either in the conventional supine position, either in the weight-bearing position. Spin echo T1w and fast spin echo T2w images were acquired with a dedicated recei…

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).

Radiomics Analysis on Gadoxetate Disodium-Enhanced MRI Predicts Response to Transarterial Embolization in Patients with HCC

Objectives: To explore the potential of radiomics on gadoxetate disodium-enhanced MRI for predicting hepatocellular carcinoma (HCC) response after transarterial embolization (TAE). Methods: This retrospective study included cirrhotic patients treated with TAE for unifocal HCC naïve to treatments. Each patient underwent gadoxetate disodium-enhanced MRI. Radiomics analysis was performed by segmenting the lesions on portal venous (PVP), 3-min transitional, and 20-min hepatobiliary (HBP) phases. Clinical data, laboratory variables, and qualitative features based on LI-RADSv2018 were assessed. Reference standard was based on mRECIST response criteria. Two different radiomics models were construc…

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

The Presence of White Matter Lesions Is Associated With the Fibrosis Severity of Nonalcoholic Fatty Liver Disease

Abstract We tested whether nonalcoholic fatty liver disease (NAFLD) and/or its histological severity are associated with vascular white matter lesions (WML) in patients with biopsy-proven NAFLD and in non-NAFLD controls. Data were recorded in 79 consecutive biopsy-proven NAFLD, and in 82 controls with normal ALT and no history of chronic liver diseases, without ultrasonographic evidence of steatosis and liver stiffness value  45 years (OR 3.09, 95% CI: 1.06–9.06, P = 0.03; and OR 11.1, 95% CI: 1.14–108.7, P = 0.03), and F2–F4 fibrosis (OR 3.36, 95% CI: 1.29–8.73, P = 0.01; and OR 5.34, 95% CI: 1.40–20.3, P = 0.01) were independently associated with WML (mostly of mild grade) by multivariate…

Ischemic hypoxic encephalopathy: The role of MRI of neonatal injury and medico-legal implication

Hypoxic ischemic encephalopathy is one of the major causes of neonatal death and neurological disability in the child, and represents the most common birth injury claim. Intrapartum asphyxia often leads to several long-term sequalae, such as cerebral palsy and/or developmental delay, epilepsy. Through the neuroimaging it's possible to identify and define the different lesioned pictures and provide useful elements to establish the moment in which the damage occurred; indeed, timing of injury is a key element in the legal arena. Magnetic resonance imaging (MRI) is emerging as one of the most important tools in identifying the etiologic of neonatal encephalopathy as well as in predicting long-…

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

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

Digital cineradiographic study of swallowing in infants with neurologic disease: Our experience

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

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

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.…

Whole-body magnetic resonance for staging and response assessment of lymphoma in a pregnant woman treated with antenatal chemotherapy

A 32-year-old pregnant female presented with bilateral supraclavicular swelling, diffuse itching and right shoulder pain. After lymph nodal biopsy, a diagnosis of nodular sclerosis Hodgkin's lymphoma was obtained. A multidisciplinary team decided to start chemotherapy before the delivery, and whole-body MRI was used to stage the disease and evaluate the response after antenatal chemotherapy. This case shows that whole-body MRI is an attractive procedure that avoids radiation exposure and contrast administration, and enables staging and follow-up of a pregnant patient without risk to the fetus.

Radiologic team performance index: A new paradigm in KPI evaluating radiology examination volumes department performance: Results of Sicilian regional healthcare system survey

Background: Efficient management of Radiologic Operative Units (ROU) because population health needs increase while healthcare systems provide less resources expendable in technologies and employee. Purpose: Create a Key Performance Indicator (KPI) defined Radiologic Team Performance Index (RTPI) able to compare the activity and efficiency of ROU operating under different environments and with different resources. Methodology/Approach: A survey was conducted in Sicilian Public Healthcare System on behalf of Sicilian Group of Italian Society of Medical Radiology (SIRM) for a total of 63 investigated ROU. Obtained informations concern workforce, emergency care organization, technologies avail…

Arterially enhancing liver lesions: significance of sustained enhancement on hepatic venous and delayed phase with magnetic resonance imaging.

Benign hepatic vascular neoplasms and vascular pseudolesions are commonly encountered in magnetic resonance (MR) imaging. Most of these benign lesions demonstrate not only arterial-phase hyperintensity, but also persistent enhancement on venous and delayed imaging, unlike most malignant hepatic masses. These features, along with other MR findings and morphological characteristics, may allow for more confident diagnosis and distinction from hepatic malignancy. The objective of our study was to illustrate the MR imaging findings of hepatic lesions that demonstrate both early arterial and sustained enhancement on hepatic venous and delayed phase.

Evaluation of anxiety level in patients wating to undergo to diagnostic radiological exams

Aims and objectives Methods and materials Results Conclusion Personal information References

Diagnostic work up of arrhythmogenic right ventricular cardiomyopathy by cardiovascular magnetic resonance.Consensus statement

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

Is trans-cranial MR-guided Focused UltraSound a repeatable treatment option? Report of a successfully re-treated patient

Background: In recent years, transcranial Magnetic Resonance-guided Focused UltraSounds (tcMRgFUS) treatments for functional neurological disorders are giving a new thrust to the field of therapeutic brain lesioning. This technique has been proven safe and effective in selected patients. Here we 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. Materials and Methods: A 72-year-old, right-handed man, who came to our observation because of a disabling tremor affecting mainly his upper right limb and refusing any invasive surgical procedure. Hi…

Presacral Myelolipoma

Many reports have described adrenal myelolipomas but there have been only a few reports of extra-adrenal myelolipomas. We describe a 74-year-old woman who came to our observation for MRI of the lumbar spine for typical lumbar back pain. In addition to signs of mild scoliosis and spondylo disc arthrosis, MR imaging revealed a presacral mass showing a heterogeneously high signal in all pulse sequences and almost completely suppressed on inversion recovery sequences for fat tissue. CT imaging confirmed the fatty nature of the lesion and no signs of bone involvement. These findings were most consistent with a diagnosis of a rare presacral myelolipoma as confirmed at histopathologic analysis. T…

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…

The challenge of the Molecular Tumor Board empowerment in clinical oncology practice: A Position Paper on behalf of the AIOM- SIAPEC/IAP-SIBioC-SIC-SIF-SIGU-SIRM Italian Scientific Societies

The development of innovative technologies and the advances in the genetics and genomics, have offered new opportunities for personalized treatment in oncology. Although the selection of the patient based on the molecular characteristics of the neoplasm has the potential to revolutionize the therapeutic scenario of oncology, this approach is extremely challenging. The access, homogeneity, and economic sustainability of the required genomic tests should be warranted in the clinical practice, as well as the specific scientific and clinical expertise for the choice of medical therapies. All these elements make essential the collaboration of different specialists within the Molecular Tumor Boar…

Dynamic versus conventional ultrasonography in the assessment of patellar tendon disease

Requisiti hardware e software: preparazione del paziente

Valori di densità TC nella diagnosi differenziale tra polmone senile ed enfisema

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

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

TRANS-CRANIAL MRI-GUIDED FOCUSED ULTRASOUND SURGERY (TCMRGFUS): ITALIAN AND WORLD-FIRST EXPERIENCE AT 1.5 TESLA

Introduction: Transcranial magnetic resonance-guided focused ultrasound surgery (tcMRgFUS) is a promising new technology for the noninvasive treatment of various brain disorders. Here, we present our preliminary results achieved with the first Italian installation of a transcranial MRI-guided focused ultrasound surgery (tcMRgFUS) certified system for functional neurosurgery. Technical issues faced to achieve a safe and effective treatment will be discussed focusing on MR high-resolution live imaging and thermometry sequences optimization. Materials and Methods: Patient enrollment was based on indication for functional neurosurgery and evidence of medication-refractory disease; a detailed me…

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…

Diffusion tensor imaging in amyotrphic lateral sclerosis: quantitative assesment ot the corticospinal tract degeneration.

Poster for European Society of NeuroRadiology. Genoa, 20-23 September 2007

Visceral Adiposity Index (VAI) as a simple indicator of “adipose tissue dysfunction” in patients with type 2 diabetes.

Although still there is no a clear definition of “adipose tissue dysfunction”, the identification of clinical and biological markers of altered fat distribution and function may provide the needed tools to early identify a condition of cardiometabolic risk. Visceral Adiposity Index (VAI) is a mathematical gender-specific index estimated with the use of simple anthropometric [(BMI and Waist circumference (WC)] and biochemical parameters [HDL cholesterol (HDL) and Triglycerides (Tg)], that in recent studies has shown to reflect accurately the degree of visceral adiposity and insulin resistance. However, although VAI has been indirectly shown to be a marker of impaired fat distribution and fun…

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…

Budd-Chiari Syndrome: spectrum of imaging findings.

A novel solution based on scale invariant feature transform descriptors and deep learning for the detection of suspicious regions in mammogram images.

Background: Deep learning methods have become popular for their high-performance rate in the classification and detection of events in computer vision tasks. Transfer learning paradigm is widely adopted to apply pretrained convolutional neural network (CNN) on medical domains overcoming the problem of the scarcity of public datasets. Some investigations to assess transfer learning knowledge inference abilities in the context of mammogram screening and possible combinations with unsupervised techniques are in progress. Methods: We propose a novel technique for the detection of suspicious regions in mammograms that consist of the combination of two approaches based on scale invariant feature …

Deferiprone versus deferoxamine in patients with thalassemia major: a randomized clinical trial.

Deferiprone has been suggested as an effective oral chelation therapy for thalassemia major. To assess its clinical efficacy, we compared deferiprone with deferoxamine in a large multicenter randomized clinical trial. One-hundred forty-four consecutive patients with thalassemia major and serum ferritin between 1500 and 3000 ng/ml were randomly assigned to deferiprone (75 mg/kg/day) (n = 71) or deferoxamine (50 mg/kg/day) (n = 73) for 1 year. The main measure of efficacy was the reduction of serum ferritin. Liver and heart iron contents were assessed by magnetic resonance. Liver iron content and fibrosis stage variations were assessed on liver biopsy by the Ishak score in all patients willin…

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

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

Atherosclerotic pattern of coronary myocardial bridging assessed with CT coronary angiography

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

Role of virtopsy in the postmortem diagnosis of drowning

Aims and objectives Methods and materials Results Conclusion Personal information References

Multislice multiecho T2* cardiovascular magnetic resonance for detection of the heterogeneous distribution of myocardial iron overload.

Purpose To assess the tissue iron concentration of the left ventricle (LV) using a multislice, multiecho T2* MR technique and a segmental analysis. Materials and Methods T2* multiecho MRI was performed in 53 thalassemia major patients. Three short-axis views of the LV were obtained and analyzed with custom-written software. The myocardium was automatically segmented into 12 segments. The T2* value on each segment as well as the global T2* value were calculated. Cine dynamic images were also obtained to evaluate biventricular function parameters by quantitative analysis. Results For the T2* global value, the coefficient of variation (CoV) for intra-/interobserver and interstudy reproducibili…

Focused Ultrasound Effects on Osteosarcoma Cell Lines

MRI guided Focused Ultrasound (MRgFUS) has shown to be effective therapeutic modality for non-invasive clinical interventions in ablating of uterine fibroids, in bone metastasis palliative treatments, and in breast, liver, and prostate cancer ablation. MRgFUS combines high intensity focused ultrasound (HIFU) with MRI images for treatment planning and real time thermometry monitoring, thus enabling non-invasive ablation of tumor tissue. Although in the literature there are several studies on the Ultrasound (US) effects on cell in culture, there is no systematic evidence of the biological effect of Magnetic Resonance guided Focused Ultrasound Surgery (MRgFUS) treatment on osteosarcoma cells, …

Impatto della Cardio-TC in una popolazione di giovani adulti

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

Evaluation of Cardiac Volumetric and Functional Parameters

EMERGING ROLE OF ULTRASOUND IMAGING ASSOCIATED TO CLINICAL NEUROPHYSIOLOGY AS A SUPPLEMENTARY DIAGNOSTICS TECHNIQUE OF PERIPHERAL NERVES PATHOLOGIES: A SICILIAN EXPERIENCE

PURPOSE: to show the relevance of peripheral nerve ultrasound imaging as a supplementary technique in a clinical neurophysiological evaluation. METHODS: peripheral nerves ultrasound (US) examination was performed in patients with a medical history of nerve entrapment and/or post-traumatic neuropathy but with clinical or neurophysiological unusual findings. A 10-18 MHz transducer was used. RESULTS: we recruited 50 patients with clinical evidence of peripheral neuropathies (25M, 25F): 24 median nerves, 1 anterior interosseous, 14 ulnar, 3 brachial plexus, 2 posterior interosseus, 1 superficial radial, 1 superficial peroneal and 4 common peroneal nerves. Overall 20/50 patients had a history of…

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

Physical capacity in performing daily activities is reduced in scleroderma patients with early lung involvement

Background and Aims Patients with systemic sclerosis (SSc) often complain reduced capacity at submaximal exercise; conversely, physical capacity in performing daily duties has never been measured in SSc. The aim of this study is to evaluate this performance and its correlates, in patients with SSc compared with healthy controls, in a free-living setting. Methods Twenty-seven outpatients with stable SSc and 11 controls were recruited. Physical activity was assessed by portable multiple sensor device (SenseWear Armband) worn for at least 6 days. Physical activity duration (PAD; in minutes) for non-sedentary activities and physical activity level (PAL = total daily energy/resting energy expend…

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

Virtual autopsy con TCMS: nostra esperienza su un caso di morte accidentale da arma da fuoco.

abstractita

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

Sviluppo di un software per l’analisi di immagini di Diffusion Kurtosis Imaging

L’analisi mediante RM del tensore di diffusione (Diffusion Tensor Imaging, DTI) consente di valutare anche in vivo e con modalità non invasive il processo di diffusione delle molecole d’acqua nei tessuti biologici. La peculiare organizzazione di alcuni tessuti biologici (es: muscoli, sostanza bianca del sistema nervoso centrale e tessuti ad alta cellularità) influenza tale fenomeno rendendolo anisotropo e quindi ben valutabile con tali tecniche di studio. Nonostante i grandi vantaggi di tale tecnica, il DTI è basato su un modello molto semplificato che assume che lo spostamento per diffusione segua un profilo gaussiano il che è molto raro in un ambiente variegato come i tessuti biologic…

Chirurgia trans-cranica mediante ultrasuoni focalizzati ad alta intensità su guida RM: esperienza preliminare a 1,5T (prima paziente trattata)

Presentiamo i risultati preliminari ottenuti con la prima istallazione italiana di un’apparecchiatura per la neurochirurgia funzionale mediante ultrasuoni focalizzati ad alta intensità su guida RM (trans-cranial MRI-guided Focused Ultrasound Surgery, tcMRgFUS); si tratta tra l’altro della prima apparecchiatura tcMRgFUS al mondo mai installata su uno scanner RM da 1,5T. Tale apparecchiatura è destinata a trattamenti di neurochirurgia funzionale di pazienti con tremore essenziale (Essential Tremor, ET), Parkinson idiopatico (Parkinson Disease, PD) prevalentemente tremorigeno e dolore neuropatico (Neuropa- thic Pain, NP). Sanno presentati i risultati ottenuti con i primi pazienti sottoposti …

Reduced exercise capacity and impaired pulmonary function in patients with scleroderma

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

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

Caecal leiomyoma detected by whole-body MRI in a patient with Hodgkin lymphoma: first case report

Introduction. Hodgkin Lymphoma (HL) is one of the most curable malignant diseases. Modern treatments, like the combined radiochemotherapy and stem cell transplantation, have increased the number of malignant disease survivors. However, HL survivors are at risk of long-term effects, including the development of solid tumors. Secondary neoplasms are a major cause of late morbidity and mortality following treatment for HL. Case report. We report the case of a male patient, treated for HL by chemotherapy, who developed a large leiomyoma of the cecum one year after the treatment. A whole-body Magnetic Resonance (WBMRI) scan performed during the follow-up allowed the detection of this incidental …

Sicilian Byzantine Icons through the Use of Non-Invasive Imaging Techniques and Optical Spectroscopy: The Case of the Madonna dell&rsquo;Elemosina

The iconographic heritage is one of the treasures of Byzantine art that have enriched the south of Italy, and Sicily in particular, since the early 16th century. In this work, the investigations of a Sicilian Icon of Greek-Byzantine origin, the Madonna dell’Elemosina, is reported for the first time. The study was carried out using mainly non-invasive imaging techniques (photography in reflectance and grazing visible light, UV fluorescence, infrared reflectography, radiography, and computed tomography) and spectroscopic techniques (X-ray fluorescence and infrared spectroscopy). The identification of the constituent materials provides a decisive contribution to the correct historical and arti…

A rare case of pedunculated bronchial hemangioma

We describe a rare case of pedunculated endobronchial hemangioma observed in a 60 years old patient complaining of chronic productive cough and accessional dyspnea which had been progressively worsening over 20 years. The lesion was first noticed at fiberoptic bronchoscopy; then computed tomography scan was performed and integrated with tridimensional reconstruction techniques. Pathology showed the picture of a vascular neoplasm, compatible with capillary hemangioma. The lesion was submitted to laser-assisted endoscopic removal in order to relieve the obstruction, leading to remission of symptoms.

Dependence of MRI sensitivity of Fricke gel dosimeters exposed to clinical photons beams on ferrous ammonium sulfate content

Sonographic examination of epiaortic vessels in patients with peripheral vertigo

To evaluate the utility of echo-color-Doppler ultrasonography (CDU) of extracranial brain-supplying vessels in patients with peripheral vertigo of unknown origin.One-hundred-fifty-six patients (study group; 42 male and 114 female; mean age 61.86 ± 14.14) and 161 patients (control group; 80 male and 81 female; mean age 62.31 ± 13.69) were prospectively evaluated with CDU of extracranial brain-supplying vessels. Plaques in common and/or internal carotid artery (CA), arterial wall intima-media thickness (IMT) of common CA and peak systolic velocity (PSV) and resistive index (RI) of vertebral arteries (VA) were evaluated. Parametric (t-test) and non-parametric (Mann-Whitney U-test and Kolmogoro…

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

Imaging dell’ischemia mesenterica mediante TC Multistrato

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

Assessment of treatment response in hepatocellular carcinoma: a review of literature

Non invasive diagnosis in a case of bronchopulmobary sequestration and proposal of diagnostic algorithm

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

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

The presence of white matter lesions is not associated with non-alcoholic fatty liver disease but with its histological severity

Assessment of large and small airways wall thickness by HRCT in asthma

Purpose Methods and Materials Results Conclusion References Personal Information

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

APPLICAZIONI DELLA TC SPIRALE MULTIDETECTORE ALLO STUDIO DI REPERTI SCHELETRICI E DI CORPI MUMMIFICATI

A fully automatic 2D segmentation method for uterine fibroid in MRgFUS treatment evaluation

PurposeMagnetic Resonance guided Focused UltraSound (MRgFUS) represents a non-invasive surgical approach that uses thermal ablation to treat uterine fibroids. After the MRgFUS treatment, an operator must manually segment the treated fibroid areas to evaluate the NonPerfused Volume (NPV). This manual approach is operator-dependent, introducing issues of result reproducibility, which could lead to errors in the subsequent follow-up phase. Moreover, manual segmentation is time-consuming, and can have a negative impact on the optimization of both machine-time and operator-time. MethodTo address these issues, in this paper a novel fully automatic method based on the unsupervised Fuzzy C-Means cl…

3D CT scan for perioperative identification of anatomical variations of lungs.

Aim: The aim of this study is to investigate anatomical lung variations and vascular patterns using volumetric 3D computed tomography (CT) representations. Methods &amp; results: We considered 24 major thoracic surgery performed in our ward. In these, we discovered some interesting anatomical variations of the main pulmonary fissures. These findings were not visible on the plain x-ray or during routine examination of a preoperative CT scan. After re-examination of 3D CT scan reconstruction the anatomical variations were detected. Discussion: General thoracic surgeons must familiarize themselves with anatomical variations in lungs. 3D images may aid the general thoracic surgeon in performin…

A rare case of Enchondromatosis of the knees and hands with involvement of Hoffa's fat pad and peri-articular soft-tissues

We report a case of a 56-year old man with chronic pain in both knees for several years. This patient had already undergone surgery on his left knee in 2002 after an x-ray showed multiple lytic and well margined lesions in the distal femur and proximal tibia with ground-glass matrix, involving Hoffa's fat pad and the patellar ligament. Histology was consistent with an enchondroma. The most recent MRI examination showed enchondromatosis involving both knees with bilateral extension into Hoffa's fat pad and the patellar ligament. Subsequently, we performed an additional radiographic examination of the hands and feet, as well as an MRI of both hands to identify other possible enchondromas in t…

Right coronary artery arising from pulmonary trunk: assessment with conventional coronary angiography and multislice computed tomography coronary angiography.

We present a case of a 59-year-old man who was admitted to the hospital because of atypical chest pain and dyspnea. Conventional coronary angiography showed an anomalous origin of the right coronary artery from the pulmonary trunk. The patient underwent multislice computed tomography in order to clarify the origin and course of the anomalous vessel. The aim of this report is to emphasize the role of multislice computed tomography as an accurate noninvasive imaging tool in the evaluation of coronary artery anomalies.

Imaging ecografico post-terapia ablativa

ASSESSMENT OF BRAIN METASTASES VOLUME CONTROL DURING STEREOTACTIC RADIOSURGERY BY LONGITUDINAL REGION GROWTH MR IMAGE SEGMENTATION ANALYSIS

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…

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

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 …

Role of Color Doppler Ultrasonography to Address the treatment of Epicondylitis with Mini-Invasive Techniques.

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

MR imaging of perianal fistulas in Crohn's disease: Sensitivity and specificity of STIR sequences

Introduction Although some studies proved the role of STIR sequences in the evaluation of perianal fistulas in Crohn's Disease (CD), contrast medium is still injected in many institutions since there is not a validated reference MR protocol. Our purpose was to evaluate the role of the STIR sequence in the detection and characterization of perianal fistulae comparing it to the post-contrast T1 sequence and correlating it with rectal examination under anesthesia. Materials and methods We retrospectively reviewed all clinical records of 31 CD patients, suspected of having perianal fistulas, who had been submitted to an MR study before and after contrast medium injection and surgical exploratio…

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

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

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

Purpose Methods and Materials Results Conclusion References Personal Information

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

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…

The presence of White Matter Lesions is not associated with Non-alcoholic Fatty Liver Disease but with its histological severity

246. Analysis of signal-to-noise ratio for a 2-channels coil developed to enable transcranial Magnetic Resonance-guided Focused Ultrasound Surgery (tcMRgFUS) with 1.5 T MRI scanners

Abstract Purpose In recent years trans-cranial Magnetic Resonance-guided Focused Ultrasound Surgery (tcMRgFUS) treatments have aroused large scientific and medical interest [1] . Usually, tcMRgFUS systems are integrated with 3 T systems which allow the use of the body RF coil for both real time imaging and MR-thermometry. At University Hospital of Palermo there is the world-first installation of a tcMRgFUS system integrated with a 1.5 T scanner. Here we present the characterization in terms of signal-to-noise ratio (SNR) of a dedicated RF coils suitably developed (by InSightec) to enable tcMRgFUS treatments with 1.5 T MR units. Methods and materials The focused ultrasound equipment (ExAblat…

Brain Mapping-Aided SupraTotal Resection (SpTR) of Brain Tumors: The Role of Brain Connectivity

Brain gliomas require a deep knowledge of their effects on brain connectivity. Understanding the complex relationship between tumor and functional brain is the preliminary and fundamental step for the subsequent surgery. The extent of resection (EOR) is an independent variable of surgical effectiveness and it correlates with the overall survival. Until now, great efforts have been made to achieve gross total resection (GTR) as the standard of care of brain tumor patients. However, high and low-grade gliomas have an infiltrative behavior and peritumoral white matter is often infiltrated by tumoral cells. According to these evidences, many efforts have been made to push the boundary of the re…

Movement abnormalities in the left ventricle of Thalassemia Major patients

Aims and objectives Methods and materials Results Conclusion Personal information References

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…

Hypogonadotrophic Pituitary Insufficiency in Transfusional Hemochromatosis Complicating Thalassemia Major: MR Imaging

To identify pituitary iron overload in patients with transfusion-dependent thalassemia major causing secondary hypogonadism, we prospectively evaluated signal intensity abnormalities of the anterior lobe of the pituitary gland of 30 patients comparing spin-echo, gradient-echo imaging and pituitary T2 relaxation times measurement. We found that pituitary iron overload can best be assessed by MR imaging using gradient-echo T2*-weighted technique to establish signal reduction in the anterior lobe of the pituitary gland. This finding is correlated to increasing serum ferritin level — a parameter that reflects the severity of iron overload, and is more evident in patients with secondary hypogon…

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

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

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

The loss of the beneficial effect of deep inspiration (DI) in COPD is associated with severity of disease

Alterazioni degli effetti broncodilatatori della inspirazione profonda in pazienti con Sclerosi Sistemica

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

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

MultiSlice human organ extraction based on GVF

Segmentation techniques based on active contours algorithm are widely used in medical imaging. Unfortunately, they require a lot of parameters to be used and this can rep- resent an issue for those physicians with not much informatics skills. This paper proposes a software tool which allows to segment multiple slice can differ organ extraction setting a small number of parameters. Moreover, the tool offers the functionality to perform a multiple segmentation the same time, so that an entire volume composed by hundreds slices can be segmented.

CT imaging of acute and chronic pyelonephritis: a practical guide for emergency radiologists

Contrast-enhanced CT is not routinely indicated in uncomplicated urinary infections, but it may be necessary in patients with specific risk factors (i.e., diabetes, immunocompromised patients, history of stones, or prior renal surgery) or in patients not responding to antibiotics and in detecting complications of pyelonephritis. CT is the gold standard for imaging assessment of pyelonephritis severity. Imaging appearance of acute pyelonephritis, including focal (i.e., wedge-shaped zones of decreased attenuation or hypodense mass) and diffuse (i.e., global enlargement, poor parenchymal enhancement, lack of excretion of contrast, fat stranding) forms, needs to be differentiated from renal inf…

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

Focal nodular hyperplasia: typical and atypical MR imaging findings with emphasis on the use of contrast media

LI-RADS ancillary features favoring benignity: is there a role in LR-5 observations?

The Liver Imaging Reporting and Data System algorithm allows category downgrade in the presence of ancillary features (AFs) favoring benignity, even in observations categorized as LR-5. This study aims to assess the role of AFs favoring benignity in LR-5 observations and their impact on category downgrade. This study included high-risk patients with at least one LR-5 observation imaged with gadoxetate disodium MRI. Three readers with different experience levels independently evaluated the presence of AFs favoring malignancy (not hepatocellular carcinoma (HCC) in particular and HCC in particular) and AFs favoring benignity. Category downgrade was considered possible in the presence of ≥ 1 AF…

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

Improvement of heart iron with preserved patterns of iron store by CMR-guided chelation therapy

[Formula: see text] multislice multiecho cardiac magnetic resonance (CMR) allows quantification of the segmental distribution of myocardial iron overload (MIO). We evaluated whether a preferential pattern MIO was preserved between two CMR scans in regularly chelated thalassaemia major (TM) patients.We evaluated prospectively 259 TM patients enrolled in the MIO in Thalassaemia (MIOT) network with a CMR follow-up (FU) study at 18 ± 3 months and significant MIO at baseline. The [Formula: see text] in the 16 segments and the global value were calculated. Four main circumferential regions (anterior, septal, inferior and lateral) were defined. We identified two groups: severe (n = 80, global [For…

Semi-automatic Brain Lesion Segmentation in Gamma Knife Treatments Using an Unsupervised Fuzzy C-Means Clustering Technique

MR Imaging is being increasingly used in radiation treatment planning as well as for staging and assessing tumor response. Leksell Gamma Knife (R) is a device for stereotactic neuro-radiosurgery to deal with inaccessible or insufficiently treated lesions with traditional surgery or radiotherapy. The target to be treated with radiation beams is currently contoured through slice-by-slice manual segmentation on MR images. This procedure is time consuming and operator-dependent. Segmentation result repeatability may be ensured only by using automatic/semi-automatic methods with the clinicians supporting the planning phase. In this paper a semi-automatic segmentation method, based on an unsuperv…

Automatic Volumetric Liver Segmentation Using Texture Based Region Growing

In this paper an automatic texture based volumetric region growing method for liver segmentation is proposed. 3D seeded region growing is based on texture features with the automatic selection of the seed voxel inside the liver organ and the automatic threshold value computation for the region growing stop condition. Co-occurrence 3D texture features are extracted from CT abdominal volumes and the seeded region growing algorithm is based on statistics in the features space. Each CT volume is composed by 230 slices, having 512 x 512 pixels as spatial resolution, and 12-bit gray level resolution. In this initial feasible study, 5 healthy volunteer acquisitions has been used. Tests have been p…

Evaluation of Cardiac Volumetric and Functional Parameters

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

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

Focal confluent fibrosis: findings at CT and MRI in the cirrhotic liver

Focal confluent fibrosis: findings at CT and MRI in the cirrhotic liver Nome del convegno: European Congress of Radiology-ECR 2004 Luogo del convegno: Vienna Dettaglio tipologia d'Ateneo: 9 - Abstract di Comunicazioni o Poster di Congressi internazionali pubblicati (anche on line)

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

Standardized T2* map of normal human heart in vivo to correct T2* segmental artefacts.

A segmental, multislice, multi-echo T2* MRI approach could be useful in heart iron-overloaded patients to account for heterogeneous iron distribution, demonstrated by histological studies. However, segmental T2* assessment in heart can be affected by the presence of geometrical and susceptibility artefacts, which can act on different segments in different ways. The aim of this study was to assess T2* value distribution in the left ventricle and to develop a correction procedure to compensate for artefactual variations in segmental analysis. MRI was performed in four groups of 22 subjects each: healthy subjects (I), controls (II) (thalassemia intermedia patients without iron overload), thala…

A novel automated tool for calculating upper airways volume in patients with isolated Pierre Robin Sequence (IPRS).

Purpose Methods and Materials Results Conclusion References Personal Information

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

Coplanar Indirect-Navigated Intraoperative Ultrasound: Matching Un-navigated Probes With Neuronavigation During Neurosurgical Procedures. How We Do It.

BACKGROUND Intraoperative ultrasound (IOUS) is becoming more and more adopted in neurosurgery, since it has been associated to greater extent of resection (EOR) and to gross total resection (GTR) during brain tumor surgery. IOUS main limitations are spatial resolution, width and orientation of the field of view and scan quality, which are operator-dependent. Furthermore, most neurosurgeons are not confident with this technique, which needs a long learning curve in order to identify and interpret anatomic structures. OBJECTIVE To describe an effective procedure to take advantages of both IOUS and neuronavigation in case of lack of a navigated ultrasound system. METHODS We propose a reliable …

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.

Hybrid Hyaluronic Acid versus High Molecular Weight Hyaluronic Acid for the Treatment of Hip Osteoarthritis in Overweight/Obese Patients

Background: Obesity is the main risk factor for hip osteoarthritis, negatively affecting the outcome of the disease. We evaluated the effectiveness of viscosupplementation with hybrid hyaluronic acid compared to that with high molecular weight hyaluronic acid in overweight/obese patients with hip osteoarthritis (OA). Methods: 80 patients were divided into two groups: a treatment group received two ultrasound-guided intra-articular hip injections of hybrid HA 15 days apart; a control group received a single ultrasound-guided infiltration with medium-high molecular weight hyaluronic acid (1500&ndash;2000 kDa). We assessed the pain, functional and cardiovascular capacity of the patients at bas…

AGATSTON SCORE E MARKER DI ATEROGENESI IN PAZIENTI CON INSUFFICIENZA RENALE CRONICA

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

Patologie renali chirurgiche

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

Ankle impingement syndromes: classification and role of diagnostic imaging.

Osteonecrosi individuate mediante RM whole body in pazienti con Linfoma di Hodgkin trattati mediante BEACOPP.

Scopo: Il trattamento del Linfoma di Hodgkin (LH) ha condotto al raggiungimento di elevati tassi di sopravvivenza [1]. Il protocollo ABVD (Doxorubicina, Bleomicina, Vinblastina e Dacarbazina) è stato considerato per molto tempo il regime chemioterapico standard nei pazienti con LH [2], grazie a una ben documentata efficacia e una scarsa tossicità. Molti studi hanno dimostrato la maggiore efficacia del protocollo BEACOPP (Bleomicina, Etoposide, Doxorubicina, Ciclofosfamide, Vincristina, Procarbazina, Prednisone) rispetto all'ABVD [3], al costo di una maggiore tossicità. L'osteonecrosi [ON] è una possibile complicanza della chemioterapia che può compromettere la qualità di vita del paziente, …

Neurophysiological and ultrasonographic exams in nerve patologies: diagnostic work-up and monitoring.

Introduzione: le patologie dei nervi sono causa di disabilità nella popolazione giovane adulta affetta e motivo di contenzioso medico-legale per molti chirurghi. Obiettivi: valutare la rilevanza dell’ecografia del nervo e dell’esame neurofisiologico nella valutazione prechirurgica e nel follow-up post-chirurgico ai fini diagnostici, prognostici e di adeguata programmazione terapeutica. Materiali e Metodi: pazienti con patologia da intrappolamento o post-traumatica sono stati sottoposti a valutazione clinica, neurofisiologica ed ecografica. Risultati: abbiamo studiato 50 neuropatie (25M, 25F): 23 nervi mediani, 1 interosseo anteriore, 14 nervi ulnari, 3 plessi brachiale, 2 interossei posteri…

Impatto del tema della radioprotezione nella letteratura radiologica nazionale italiana

Evaluate the interest aroused in the Italian radiological literature by radioprotection in the period 2004-2014 and its impact and development in national scientific research.

GI/Liver/Biliary/Pancreas

Resectable and borderline resectable pancreatic ductal adenocarcinoma: Role of the radiologist and oncologist in the era of precision medicine

The incidence and mortality of pancreatic ductal adenocarcinoma are growing over time. The management of patients with pancreatic ductal adenocarcinoma involves a multidisciplinary team, ideally involving experts from surgery, diagnostic imaging, interventional endoscopy, medical oncology, radiation oncology, pathology, geriatric medicine, and palliative care. An adequate staging of pancreatic ductal adenocarcinoma and re-assessment of the tumor after neoadjuvant therapy allows the multidisciplinary team to choose the most appropriate treatment for the patient. This review article discusses advancement in the molecular basis of pancreatic ductal adenocarcinoma, diagnostic tools available fo…

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

Re: Small solid renal masses: Characterization by diffusion-weighted MRI at 3 T. A reply.

No abstract available.

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

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

Imaging of Substantia Nigra in Parkinson's Disease: A Narrative Review.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder, characterized by motor and non-motor symptoms due to the degeneration of the pars compacta of the substantia nigra (SNc) with dopaminergic denervation of the striatum. Although the diagnosis of PD is principally based on a clinical assessment, great efforts have been expended over the past two decades to evaluate reliable biomarkers for PD. Among these biomarkers, magnetic resonance imaging (MRI)-based biomarkers may play a key role. Conventional MRI sequences are considered by many in the field to have low sensitivity, while advanced pulse sequences and ultra-high-field MRI techniques have brought many advantages, partic…

Looking into the architecture of the brain with MRI: quantification of non-Gaussian water diffusion by Diffusion Kurtosis Imaging (DKI)

The aim of this work is the definition of an MRI protocol for Diffusion Kurtosis Imaging (DKI) by using a 1.5T clinical scanner and the development of a software for DKI analysis.

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

Correlazioni tra reperti radiologici ed anatomici in un caso di grave traumatismo cranico

Common and uncommon pitfalls in pancreatic imaging: it is not always cancer.

Despite advances in multimodality imaging of pancreas, there is still overlap between imaging findings of several pancreatic/peripancreatic disease processes. Pancreatic and peripancreatic non-neoplastic entities may mimic primary pancreatic neoplasms on ultrasound, CT, and MRI. On the other hand, primary pancreatic cancer may be overlooked on imaging because of technical and inherent factors. The purpose of this pictorial review is to describe and illustrate pancreatic imaging pitfalls and highlight the basic radiological features for proper differential diagnosis.

Heart rate control with oral ivabradine in computed tomography coronary angiography: a randomized comparison of 7.5 mg vs 5 mg regimen.

Background: Heart rate (HR) reduction is essential to achieve optimal image quality and diagnostic accuracy with computed tomography coronary angiography (CTCA). Administration of oral ivabradine seems to be more effective than beta-blockade in reducing HR in patients referred for CTCA. Methods: Two-hundred-fifty-nine consecutive patients referred for CTCA were prospectively enrolled. Patients not receiving beta-blocker at baseline (group 1) and those with beta-blocker therapy (group 2) were enrolled in the study. Each group was randomized into 3 parallel arms with 1:1:1 allocation. Patients who did not receive beta-blocker at baseline: underwent CTCA without beta blocker (n=49), and receiv…

Influence of myocardial fibrosis and blood oxygenation on heart T2* values in thalassemia patients

Purpose To determine whether T2* measurements quantifying myocardial iron overload in thalassemia patients are influenced by myocardial fibrosis and blood oxygenation. Materials and Methods Multislice multiecho T2* was performed in 94 thalassemia patients in order to quantify myocardial iron overload. The left ventricle was automatically segmented into a 16-segment standardized heart model, and the T2* value on each segment as well as the global T2* were calculated. Delayed enhanced cardiovascular magnetic resonance (DE-CMR) images were obtained to detect myocardial fibrosis. The blood oxygenation was assessed by the noninvasive measurement of partial pressure of oxygen (pO2). Results Myoca…

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

Simulazioni numeriche e test di applicabilità clinica della Diffusion Kurtosis Imaging su tomografi RM da 1.5 Tesla

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

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 …

Utility of 3 Tesla diffusion-weighted magnetic resonance (DWMR) imaging for the characterisation of small solid renal tumours

Purpose: To determine the utility of apparent diffusion coefficients (ADCs) for the characterisation of small solid renal lesions. Methods and Materials: 26 patients (GFR 30-60 mL/min) with 39 small (1-3 cm) solid renal masses [16 RCCs (10 clear cell types; 6 other types); 18 AMLs (10 fat-containing; 8 minimal-fat) and 5 oncocytomas] were examined on a 3 T system using DW-SS-EPI (b-values 0, 1000 s/mm2). The ADC of the lesions and the ADC of kidney were evaluated. Receiver operator characteristic analysis was performed to evaluate the diagnostic value of ADC for differentiating clear cell RCCs from other type RCCs, AMLs and oncocytomas. Results: The mean ADC of the lesions [1.22± 0.27 28 mm…

Influence of heart rate in the selection of the optimal reconstruction phase in clinical routine multi-slice coronary angiography

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)

Coronary artery anomalies: incidence, pathophysiology, clinical relevance and role of diagnostic imaging

Conventional coronary angiography is the gold standard for the diagnosis of coronary artery anomalies. Coronary anomalies are relatively rare findings in patients undergoing conventional coronary angiography for suspected obstructive coronary artery disease. Recently, the increasing performance of diagnostic techniques, such as electron beam tomography (EBT), magnetic resonance (MR) and, more recently, multislice computed tomography (MSCT), has enabled their application to cardiac imaging. MSCT, in particular, has a prominent role in coronary imaging due to its spatial and temporal resolution and three-dimensional capabilities. We report the incidence and pathophysiology of coronary artery …

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

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

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

Differential diagnosis of vascular necrosis of the femoral head (AVN) and transient hip osteoporosis (THO): role of MRI

Pulmonary functional and radiological correlations of nutritional status and physical activity in systemic sclerosis

Purpose Methods and Materials Results Conclusion References Personal Information

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.

APPLICATION OF A FLOW CHART TO EVALUATE PLACEMENT OF UMBILICAL VENOUS CATHETERS ON FRONTAL RADIOGRAM IN RADIOLOGIST RESIDENT

Aims and objectives Methods and materials Results Conclusion Personal information References

Ruolo delle ricostruzioni 3D Volume Rendering con TC multidetettore (TCMD) a 40 strati nella valutazione pre-operatoria delle neoplasie renali

Valutazione dell’instabilità laterale di caviglia con RM dedicata in ortostatismo. Esperienza preliminare.

SCOPO: Dimostrare l'utilità dell'esame in ortostatismo della caviglia con una RM dedicata nella valutazione di pazienti con evidenza clinica di instabilità laterale di caviglia. DISEGNO DELLO STUDIO: Retrospettivo. MATERIALI E METODI: Abbiamo valutato gli esami RM di caviglia di 29 pazienti, effettuati tra settembre 2008 e giugno 2009 con macchina RM dedicata da 0,25 Tesla (G-Scan, Esaote Spa, Genova, Italia). Sono state eseguite, con bobina ricevente dedicata per la caviglia, sequenze SE-T1 pesate, TSE-T2 pesate, 3D-Steady-State (SSE), e STIR, sia in posizione supina che ortostatica. Tre radiologi con esperienza in radiologia muscolo-scheletrica hanno valutato, in consenso, segni RM di ins…

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…

CONTROLLO DELLA PERVIETA’ DEI VASI CORONARICI IN PAZIENTI CON CARDIOPATIA ISCHEMICA MEDIANTE TAC MULTISTRATO

HIPPOCAMPAL REVERSIBLE LESIONS IN A CASE OF TRANSIENT GLOBAL AMNESIA

PURPOSE: We present a case of transient global amnesia (TGA) onset in a 52-year-old male with a medical history of migraine. METHODS: Patient was taken to ER by his colleagues which reported that after an emotional stress he suddenly appeared perplexed and started asking repetitive questions. In ER a neurological examination excluded other neurological signs or symptoms and it was confirmed that cognitive impairment was limited to the amnesia domain; electroencephalography was unremarkable and he had no history of epileptic seizures or head trauma. At the neurologic examination Capland and Hodges criteria were fulfilled and the diagnostic hypothesis of TGA was placed. He underwent to a brai…

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…

POST-THALAMOTOMY NEUROFUNCTIONAL FINDINGS ON PATIENTS TREATED WITH TRANS-CRANIAL MAGNETIC RESONANCE GUIDED FOCUSED ULTRASOUND SURGERY (TCMRGFUS): PRELIMINARY RESULTS

BACKGROUND AND PURPOSE: We present functional connectivity (FC) changes found in the very first patients treated with the first Italian installation of a trans-cranial MRI-guided Focused Ultrasound Surgery (tcMRgFUS) certified system for functional neurosurgery. TcMRgFUS is a promising new technique for non-invasive treatment of neurologic disorders such as Essential Tremor, tremor associated to Parkinson's Disease and Neuropathic Pain. TcMRgFUS is able to focally target and destroy specific regions in the brain through intact skull, by using a high intensity focused ultrasound beam. Resting state functional Magnetic Resonance Imaging (RS-fMRI) analyses focuses on spontaneous low frequency …

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

A Semi-automatic Multi-seed Region-Growing Approach for Uterine Fibroids Segmentation in MRgFUS Treatment

Fibroids are benign tumors growing in the uterus. Most of fibroids do not require treatment unless they are causing symptoms. Traditional surgery treatments, like myomectomy and hysterectomy, are very invasive therapeutic approaches which not always preserves reproductive potential of the woman. MRgFUS, performed with Insightec ExAblate 2100 equipment, is a new and noninvasive technique for uterine fibroids treatment, not requiring hospitalization and recovery time for patients. An initial assessment of MRgFUS treatment is made by computing the ablated volume of uterine fibroid. In this paper a semi-automatic approach, based on region-growing segmentation technique, is proposed. The impleme…

La sindrome da conflitto ischio-femorale: valutazione diagnostica con RM

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

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

HIGH-RESOLUTION ULTRASONOGRAPHY (HRUS) OF THE MENISCAL CYST OF THE KNEE : OUR EXPERIENCE

Purpose. This study was undertaken to assess the diagnostic accuracy of high-resolution ultrasonography (HRUS) in the detection of meniscal cysts. Materials and methods. Over a 2-year period, 1,857 patients underwent magnetic resonance imaging (MRI) of the knee for traumatic or degenerative disorders. All patients with MRI evidence of a meniscal cyst were studied by HRUS. HRUS was also performed on an equal number of patients without MRI evidence of meniscal cyst who were used as a control group. All HRUS examinations were conducted by a radiologist blinded to the MRI findings. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of HRUS were assesse…

Long Term Clinical Follow-up and Graft Patency of Offpump vs On-pump Coronary Artery Surgery in Patients with ST-Segment Elevation Myocardial Infarction

Confronto tra RM Whole Body, TC/PET e biopsia osteomidollare, nella valutazione dell’interessamento midollare in 104 pazienti con linfoma.

Scopo: Parte della stadiazione dei linfomi prevede la valutazione dell'interessamento del midollo osseo (IMO) mediante biopsia osteo-midollare (BOM) [1]. Tuttavia, secondo le ultime linee guida, la BOM non è più indicata per lo studio dei linfomi di Hodgkin [2]. La TC/PET è la tecnica di imaging standard per la stadiazione dei linfomi FDG-avidi, mentre la TC è indicata nei pazienti con istotipi non FDG-avidi [1]. Molti studi hanno dimostrato affidabilità ed elevata accuratezza diagnostica della Risonanza Magnetica Whole Body (RM-WB) nella stadiazione dei linfomi [3,4]. Lo scopo del nostro studio è stato quello di confrontare RM-WB, TC/PET e BOM, nella valutazione dell’IMO in pazienti con li…

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

trattamento ecoguidato della rizo artrosi con steroidi e acido ialuronico .

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…

PECULIARE EVOLUZIONE DELLA SEMEIOTICA NEURORADIOLOGICA DI UN CASO DI MALATTIA DEMIELINIZZANTE CON LESIONI PSEUDOTUMORALI

SCOPO DEL LAVORO Presentiamo un caso di una paziente di 24 anni che giunge alla nostra attenzione per la comparsa di disartria come quadro clinico d’esordio di una forma aggressiva di malattia demielinizzante di cui si valuta l’atipica evoluzione neuroradiologica delle lesioni pseudotumorali che la caratterizzano e le possibili diagnosi differenziali. MATERIALI E METODI La paziente dopo una prima valutazione in PS è stata sottoposta a TC encefalo, ricoverata presso l’U.O. di Neurologia, sottoposta a controlli RM seriati (anche con tecniche avanzate); durante la degenza è stata inoltre effettuata una biopsia stereotassica. RISULTATI La TC ha rilevato almeno tre lesioni ipodense: a sinistra…

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

Deep Learning Network for Segmentation of the Prostate Gland With Median Lobe Enlargement in T2-weighted MR Images: Comparison With Manual Segmentation Method

Purpose: Aim of this study was to evaluate a fully automated deep learning network named Efficient Neural Network (ENet) for segmentation of prostate gland with median lobe enlargement compared to manual segmentation. Materials and Methods: One-hundred-three patients with median lobe enlargement on prostate MRI were retrospectively included. Ellipsoid formula, manual segmentation and automatic segmentation were used for prostate volume estimation using T2 weighted MRI images. ENet was used for automatic segmentation; it is a deep learning network developed for fast inference and high accuracy in augmented reality and automotive scenarios. Student t-test was performed to compare prostate vol…

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…

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

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.…

Hyperintense nodule-in-nodule on hepatobiliary phase arising within hypovascular hypointense nodule: Outcome and rate of hypervascular transformation.

Purpose: To investigate the clinical implications and natural history of observations showing a &ldquo;nodule-in-nodule&rdquo; architecture on hepatobiliary phase (HBP) in a cirrhotic population. Method: This is an IRB-approved retrospective study conducted in a single institution. We identified 20 patients (11 men and 9 women, mean age 71 years, range 51&ndash;83 years) who had a hyperintense nodule on HBP arising within a larger HBP-hypointense nodule without arterial phase hyperenhancement (APHE) at gadoxetate disodium-enhanced MRI. Size and signal intensity of the nodules were evaluated in all sequences, along with the evolution of the nodules at serial MRI studies. Results: Twenty-four…

Arterially enhancing liver lesion: significance of sustained enhancement on delayed phase with MR imaging

Imaging con risonanza magnetica delle neuropatie da intrappolamento della spalla

Obiettivi didattici: Descrivere e caratteristiche alla risonanza magnetica (RM) delle neuropatie da intrappolamento comuni della spalla: - sindrome di Parsonage-Turner - sindrome del quadrilatero (neuropatia ascellare) - sindrome del nervo soprascapolare Introduzione: Le neuropatie da intrappolamento sono caratterizzate da alterazione della funzionalità dei nervi secondaria alla compressione da parte di forze meccaniche o dinamiche. La compressione può essere acuta, cronica o intermittente. Non di rado neuropatie compressive sono dovute a lesioni occupanti spazio, come tumori, cisti, processi infiammatori, o condizioni post-traumatiche. Descrizione: L'aspetto RM della sindrome di Parsonage-…

HRCT and scleroderma: semiquantitative evaluation of lung damage and functional abnormalities.

This study sought to validate the Warrick score in the assessment of lung involvement in systemic sclerosis (SSc) and correlate the results with functional abnormalities. In addition, we propose the use of high resolution computed tomography (HRCT) indices of alveolitis and fibrosis to discriminate between different stages of the disease.Thirty-one patients with SSc (16 with the diffuse form and 15 with the limited form) underwent functional and HRCT evaluations of the lung. The semiquantitative evaluation of radiological involvement, as proposed by Warrick, provides a score for each lesion based on the severity and the extent of the pulmonary damage. In addition to the total score, indices…

High Intensity Focused Ultrasound: opportunità e sfide della chirurgia ablativa non invasiva sotto guida a Risonanza Magnetica

40 Slices MDCT Non-Invasive Diagnostic Approach to Coronary Artery Disease

Myocardial scarring by delayed enhancement cardiovascular magnetic resonance in thalassaemia major

Background: Cardiovascular magnetic resonance (CMR) by delayed enhancement (DE) enables visualisation of myocardial scarring, but no dedicated studies are available in thalassaemia major. Objective: To investigate the prevalence, extent, clinical and instrumental correlates of myocardial fibrosis or necrosis by DE CMR in patients with thalassaemia major. Patients: 115 Patients with thalassaemia major consecutively examined at an MRI laboratory. Methods: DE images were acquired to quantify myocardial scarring. Myocardial iron overload was determined by multislice multiecho T2*. Cine images were obtained to evaluate biventricular function. Results: DE areas were present in 28/115 patients (24…

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

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?

The airway response to deep inspirations decreases with COPD severity and is associated with airway distensibility assessed by computed tomography.

In patients with mild chronic obstructive pulmonary disease (COPD), the effect of deep inspirations (DIs) to reverse methacholine-induced bronchoconstriction is largely attenuated. In this study, we tested the hypothesis that the effectiveness of DI is reduced with increasing disease severity and that this is associated with a reduction in the ability of DI to distend the airways. Fifteen subjects [Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I–II: n = 7; GOLD stage III–IV: n = 8] underwent methacholine bronchoprovocation in the absence of DI, followed by DI. The effectiveness of DI was assessed by their ability to improve inspiratory vital capacity and forced expira…

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).

Gadoxetic acid-enhanced MRI of transient hepatic enhancement differences: Another cause of hypointense observation on hepatobiliary phase

Purpose: To retrospectively determine the frequency, natural history and factors associated with the presence of transient hepatic enhancement difference showing hypointensity on hepatobiliary phase images of gadoxetic acid-enhanced MRI. Materials and methods: Gadoxetic acid-enhanced MRI of 125 patients (91 men; 34 women) with transient hepatic enhancement difference were retrospectively reviewed. Three readers qualitatively and quantitatively evaluated MR imaging features and evolution at follow up. The Chi-square test, Fisher's exact test and Kruskall-Wallis rank test were used for statistical analysis. Results: Transient hepatic enhancement difference were hypointense on hepatobiliary ph…

T2-mapping of the sacroiliac joints at 1.5 Tesla: a feasibility and reproducibility study

Objective: To evaluate the reproducibility of T2 relaxation time measurements of the sacroiliac joints at 1.5 T. Materials and methods: Healthy volunteers underwent an oblique axial multislice multiecho spin-echo sequence of the sacroiliac joints at 1.5 T. Regions of interest were manually drawn using a dedicated software by two musculoskeletal radiologists to include the cartilaginous part of the sacroiliac joints. A senior radiologist performed the measurement twice, while a resident measured once. Intra- and inter-observer reproducibility was tested using the Bland-Altman method. Association between sex and T2 relaxation times was tested using the Mann-Whitney U test. Correlation between…

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

Aggressive Angiomyxoma: unusual pelvic mass

Learning objectives Background Findings and procedure details Conclusion Personal information References

Focal nodular hyperplasia: typical and atypical MRI findings with emphasis on the use of contrast media

Focal nodular hyperplasia is a benign hypervascular hepatic tumour, frequently detected in asymptomatic patients undergoing imaging studies for unrelated reasons. Magnetic resonance imaging (MRI) generally allows a confident differential diagnosis with other hypervascular liver lesions, either benign or malignant. In addition, due to the recent development of hepatospecific MRI contrast agents, MRI concomitantly enables functional and morphological information to be obtained, thus providing important clues for the detection and characterization of focal nodular hyperplasia lesions.

Usefulness of coronary angiography with multidetector computed tomography in the evaluation of aorto-coronary bypass patency

Lung hyperinflation in COPD attenuates airway distension by deep inspiration (DI) measured with HRCT

Contrast-enhanced US of liver hemangiomas atypical at baseline US

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

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

Uncommon imaging evolutions of focal liver lesions in cirrhosis.

Objective: The purpose of this article is to describe and illustrate uncommon imaging evolutions of benign (i.e., cyst, hemangioma, focal nodular hyperplasia-like nodules, and hepatic angiomyolipoma) and malignant (i.e., HCC and non HCC malignancies) lesions in a cirrhotic liver. The content highlights relevant pathogenesis and imaging clues for proper differential diagnosis. Revision of prior imaging and knowledge of these scenarios may help the abdominal radiologist to reach a noninvasive diagnosis and direct the patient to the most appropriate clinical management. Conclusion: Uncommon imaging evolutions of focal liver lesions in cirrhosis may represent a challenge for the abdominal radio…

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…

Improving diagnostic accuracy of MDCT coronary angiography in patients with mild heart rhythm irregularities using ECG editing

OBJECTIVE. The objective of our study was to compare diagnostic accuracy of MDCT coronary angiography in a population of patients with mild heart rhythm irregularities before and after editing the ECG. SUBJECTS AND METHODS. Thirty-eight patients who underwent MDCT coronary angiography and conventional coronary angiography were enrolled in the study. The inclusion criterion was the presence of mild heart rhythm irregularities (i.e., premature beats; atrial fibrillation; mistriggering; or low heart rate, defined as 40 beats per minute or less) during the scan. All patients underwent MDCT with the following parameters: 16 detectors; collimation, 0.75 mm; gantry rotation time, 375 msec; 120 kV;…

Quantitative value of medial femoro-tibial width (FTW) with weight-bearing technique. Our experience with a modified Lyon-Schuss view.

In the period between September 2008 and February 2009, we evaluated with knee radiography a group of 30 patients with known knee osteoarthritis (OA). For each patient, two weight-bearing views of the knee were acquired, the first with a standard antero-posterior (AP) technique, the latter with a posteroanterior (PA) technique with a 10° skull-caudal incidence. The radiographs obtained were evaluated blinded by two radiologist who assessed the medial femoro-tibial width (FTW). Statistical analysis of the results, carried out with the “t” Student test, showed a statistically significant difference about FTW values between the two radiographic views (t = 5.2331 for reader 1 and t=5.1970 for r…

[Forty-slice multidetector computed tomography for non-invasive diagnostic approach to coronary artery disease]

A rare case of ruptured aneurysm of the paramedian artery of Percheron.

Introduction The artery of Percheron is a rare anatomic variant supplying bilateral medial thalamic nuclei and a variable portion of the rostral part of midbrain. Case report A 48-year-old female with massive subarachnoid hemorrhage due to a ruptured aneurysm of the paramedian artery of Percheron presented to the emergency room. Because of significant risk of recurrent intracranial hemorrhage, it was decided to proceed with endovascular embolization of the aneurysm. The patient was ultimately sent to a rehabilitation center and her presenting neurologic deficits showed significant improvements in the weeks following endovascular embolization treatment. Discussion The paramedian artery of Pe…

Airway distensibility by HRCT in asthmatics and COPD with comparable airway obstruction.

Introduction: Decreased airway distensibility (AD) in response to deep inspirations, as assessed by HRCT, has been associated with the severity of asthma and COPD. Aims: The current study was designed to compare the magnitude of AD by HRCT in individuals with asthma and COPD with comparable degrees of bronchial obstruction, and to explore factors that may influence it. Results: We enrolled a total of 12 asthmatics (M/F:7/5) and 8 COPD (7/1) with comparable degree of bronchial obstruction (FEV1% predicted mean±SEM: 69.1 ± 5.2% and 61.2 ± 5.0%, respectively; p = 0.31). Each subject underwent chest HRCT at FRC and at TLC. A total of 701 airways (range 20 to 38 airway per subject; 2.0 to 23.1 m…

Valutazione delle lesioni del tendine del sovraspinato con elastosonografia: confronto con ecografia B-mode e risonanza magnetica. Nostra esperienza.

SCOPO: Valutare l'elasticità del tendine del sovraspinato in pazienti con sospetto clinico di lesione della cuffia dei rotatori, e comparare i reperti dell'elastosonografia con quelli dell'ecografia B-mode (US) e della risonanza magnetica (RM). DISEGNO DELLO STUDIO: Prospettico. MATERIALI E METODI: Nel periodo compreso tra agosto 2008 e settembre 2009, abbiamo valutato la spalla sintomatica di 20 pazienti con elastosonografia usando una sonda lineare da 13 MHz (EUB - Hitachi 7500, Giappone). E' stato usato uno score semiquantitativo di colori differenti rappresentanti tessuto più rigido (blu) e tessuto via via meno rigido (verde, giallo, rosso). I reperti sono stati comparati con quelli del…

P1030 : The presence of white matter lesions is not associated with non-alcoholic fatty liver disease but with its histological severity

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…

Characterization of focal liver lesions

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

Cystic lymphangioma of the retroperitoneum

Semi-Automated evaluation of small bowel mural attenuation at CT enterography using different temporal windows in patients affected by active Crohn disease

Disfunzione del tessuto adiposo e diabete mellito tipo 2: scarsa utilità diagnostica della quantificazione del grasso tramite RMN.

Whole-body magnetic resonance imaging (WB-MRI) in oncology: an Italian survey.

Purpose: To perform a survey among all members of the Italian Society of Medical and Interventional Radiology (SIRM) to assess how whole-body MRI (WB-MRI) is performed in oncologic patients in Italy. Methods: On March 2019, we administered an online poll to all SIRM members about their use of WB-MRI in 2018 asking 15 questions regarding oncologic indications, imaging protocol, use of contrast media, experience in WB-MRI, duration of scan time and reporting time. Results: Forty-eight members participated to the survey. WB-MRIs/total MRIs ratio was 1%. Lymphoma was the most common indication (17/48, 35%), followed by myeloma and prostate cancer, with these three tumors representing the most c…

Nutritional evaluation and physical activity in scleroderma patients

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

VENTRICULAR DYSFUNCTION AND NUMBER OF NON COMPACTED SEGMENTS IN NON COMPACTION: NON-INDEPENDENT PREDICTORS

VENTRICULAR DYSFUNCTION AND NUMBER OF NON COMPACTED SEGMENTS IN NON COMPACTION: NON-INDEPENDENT PREDICTORS 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 affecte…

Diagnostic accuracy of 16-row multislice CT angiography in the evaluation of coronary segments

Grading dei gliomi cerebrali: ruolo combinato degli studi RM di perfusione e di spettroscopia a confronto con lo studio in tecnica RM convenzionale

Poster per il 26° Congresso Nazionale Associazione Italiana di Neuroradiologia Diagnostica e Interventistica

Bolus-test VS bolus-tracking nello studio angio-TC dei vasi epiaortici e del circolo intracranico.

Poster congresso nazionale SIRM. Verona, 11- 15 giugno 2010.

E-learning e teleradiologia: nostra esperienza con OsiriX e iChat.

Poster congresso nazionale SIRM. Verona, 11-15 giugno

Angio-RM a confronto con angiografia digitale nella diagnosi degli aneurismi cerebrali.

Poster congresso nazionale AINR. Bergamo, 20-23 Giugno 2007

Imaging con trattografia nella pianificazione chirurgica delle neoplasie cerebrali: esperienza preliminare.

Poster congresso nazionale AINR. Bergamo, 20-23 Giugno 2007

Imaging del tensore di diffusione nella SLA: esperienza preliminare nella valutazione della degenerazione dei FCS.

Comunicazione orale per il Congresso nazionale SIRM. Roma, 23-27 maggio 2008

Computed assisted radiology (CAR) nello studio della patologia vascolare aneurismatica e malformativa atero-venosa del circolo intracranico: nostra esperienza con QuickTime VR ed OsiriX.

Poster congresso nazionale SIRM. Verona, 11- 15 giugno 2010.

Massiva emorragia intratumorale causa di atipica presentazione clinica di un neurinoma cistico del cui: caratteristiche TC ed RM e analisi morfovolumetrica.

Poster per congresso nazionale AINR. Padova, 19-22 Ottobre 2011