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2 results on '"Ettore Laccetti"'

1. The Use of Ceus Software with No Contrast Media Administration in the Diagnosis of Pneumoperitoneum

Author

Michele Altiero, Giuseppina Dell’Aversano Orabona, Ettore Laccetti, Alessandro Rengo, Roberta Danzi, Federica Romano, Marco Di Serafino, Francesca Iacobellis, Giampiero Francica, Mariano Scaglione, and Luigia Romano

Subjects
acute abdomen, pneumoperitoneum, gastrointestinal perforations, emergency, contrast-enhanced US examination (CEUS), Medicine (General), R5-920
Abstract

Background: Pneumoperitoneum is defined by the presence of free air in the abdominal cavity; gastrointestinal perforation is an important cause of this pathological condition. In emergency situations, radiology is considered vital in the early detection and identification of the site and cause of the perforation, which is critical for proper surgical planning. Aim: The aim of our study was to evaluate a new diagnostic US tool, based on the US contrast-specific software generally used during contrast-enhanced US examination (CEUS), without the administration of sonographic contrast media, and to describe the specific imaging features in the detection of free intra-peritoneal air. Subjects and Methods: One hundred and fifty-seven consecutive and hemodynamically stable patients, who arrived in our E.D. with an acute abdomen between April 2018 and October 2019, underwent US and CT examination, performed by three radiologists (with 5, 5, and 25 years of experience). The US was performed first and divided into two steps, using B-mode US and both B-mode and contrast-specific software US, with no contrast media administration. All the patients underwent CT examination. Results: In 32 out of 157 patients, the surgery confirmed GI perforation. CT correctly detected 31 out of 32 patients; the contrast-specific software US identified 30 perforated patients. CT reached a sensitivity value of 97% and specificity value of 100%; contrast-specific software US demonstrated higher values than B-mode US in sensitivity (93% vs. 70%, respectively) and specificity (98% vs. 88%, respectively). Conclusion: the use of contrast-specific software in emergencies improves image quality, and reaches higher levels of sensitivity and specificity with no time delay compared to standard US examination, helping radiologists expedite diagnoses.

Published
2022
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2. MR-enterography in Crohn’s disease: what MRE mural parameters are associated to one-year therapeutic management outcome?

Author

Leonardo Pace, Fabiana Castiglione, Valeria Romeo, Antonio Rispo, Simone Maurea, Ettore Laccetti, Pier Paolo Mainenti, Anna Testa, Salvatore Guarino, Paolo Mainenti, Pier, Castiglione, Fabiana, Rispo, Antonio, Laccetti, Ettore, Guarino, Salvatore, Romeo, Valeria, Testa, Anna, Pace, Leonardo, and Maurea, Simone

Subjects
Adult, Male, Crohn’s disease, medicine.medical_specialty, Adolescent, Treatment outcome, MR-enterography, Management outcome, Disease, Conservative Treatment, Gastroenterology, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Crohn Disease, Internal medicine, Medicine, Humans, Radiology, Nuclear Medicine and imaging, Aged, Retrospective Studies, Crohn's disease, Full Paper, business.industry, Follow up studies, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Magnetic Resonance Imaging, Intestines, Treatment Outcome, MR Enterography, 030211 gastroenterology & hepatology, Female, business, Follow-Up Studies
Abstract

Objective: To investigate the association of mural parameters of MR-enterography (MRE) with one-year therapeutic management of Crohn’s disease (CD) patients. Methods: CD patients, undergone MRE with diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps between January 2017 and June 2018, were retrospectively enrolled. Extramural complications represented an exclusion criterion because of their potential influence on the intrinsic characteristic of the bowel wall. Two groups of patients were defined on the base of the therapeutic management adopted at 1-year follow-up: Medical-group and surgical-group. The following MRE parameters were evaluated: wall-thickening, longitudinal-extension, T2-fat-suppression-mural-signal, ulcers, mural-oedema, wall-enhancement-rate/pattern, DWI-scores, ADC-values, strictures. Results: 70 CD patients were enrolled. 57/70 (81.4%) were included in Medical-group and 13/70 (18.6%) in Surgical-group. ADCmean and strictures resulted to be significantly (p < 0.01) different between the two groups. The ADCmean showed to be significantly associated to conservative management [p < 0.01; OR: 0.0003; 95% CI (0.00–0.13)], while the strictures to surgical management [p < 0.01; OR: 29.7; 95% CI (4.9–179.7)]. ROC curves for ADCmean showed that AUC was 0.717 [95% CI (0.607–0.810), p < 0.01] with an optimal cut-off value of 1.081 × 10−3 mm2 s−1. A negative predictive value of 90.2% was observed associating ADCmean values > 1.081 × 10−3 mm2 s−1 to conservative therapy. 13/17 (76%) strictures with an ADCmean > 1.081 × 10−3 mm2 s−1 benefited of conservative therapy. Conclusion: ADCmean values calculated on DWI-MRE may be associated to 1-year conservative medical therapy in patients with CD without extramural complications. Advances in knowledge: ADC maps may be proposed to select CD patients with a lower burden of mural active inflammatory cells and/or fibrosis benefiting of 1-year conservative treatment.

Published
2021

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