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Ferritic ductile iron (DI) GJS 400 and high-silicon strengthened ductile irons (HSSDIs) with 3.5 and 4.5 wt% of silicon contents were produced with different cooling rates, and the microstructures were analyzed to find the main microstructure parameters. The Y-blocks GJS 400 presented good nodularity, while the heavy section GJS 400 presented some graphite degeneracy with a lower nodularity. The 3.5 wt% HSSDI shown a good nodularity, while with increasing silicon content to 4.5 wt%, significant graphite degeneracy occurred with the appearance of chunky graphite. Samples were tensile tested and the tensile data were analyzed through the physical-based constitutive Voce equation, and the Voce parameters were plotted to produce a matrix assessment diagram (MAD). Y-blocks and heavy section GJS 400 data lied on two distinct lines in MAD, and they had, however, positive and negative intercepts which meant indeed two contradictory plastic behaviors. The intercept of the best fitting line of the GJS 400 Y-blocks data was positive and so consistent with the physical meaning of Voce equation, while the intercept of the best fitting line of the GJS 400 heavy section data was negative, which meant an unexpected opposite plastic behavior. Same behavior was reported for the investigated HSSDIs, resulting in positive intercept of the best fitting line in MAD for the 3.5 wt% HSSDI data and negative intercept for the 4.5 wt% HSSDI data. The uniform strain energy density (SEDU) that is the area below the tensile flow curve up to the uniform strain, i.e., the strain where necking begins, was also investigated. SEDU resulted to be almost constant for all the GJS 400 Y-blocks tensile flow curves and 3.5 wt% HSSDI, which was typical of a sound material, while in GJS 400 heavy section and 4.5 wt% HSSDI, SEDU changed significantly in a systematic way, indicating that metallurgical defects had affected the plastic behavior. So it was concluded that in the MAD the best fitting line of the tensile data with positive intercept was a possible indication of the material soundness, while the negative intercept was indication of defected material. The results suggested that the MAD analysis produced from tensile Voce parameters can be a useful and easy tool for industry not only to classify the production routes of DIs (Si content mainly and heat treatments), but also to identify possible microstructure poorness within a single DI grade. [ABSTRACT FROM AUTHOR]

Aims: Lake Louise Criteria (LLC) are time-dependent and some acute myocarditis (AM) with preserved left ventricular ejection fraction (LVEF) could be missed, due to the limited accessibility of Cardiac Magnetic Resonance (CMR). We aimed to assess the potential value of cardiac strain measured by feature tracking (FT) imaging in this population. Methods and results: Eighty-three patients with clinically suspected AM and normal LVEF were divided into 39 "confirmed AM" (positive LLC) and 44 "suspected AM" (negative LLC). An age and gender-matched sample of 42 normal subjects underwent CMR. In all groups, FT-derived biventricular strains and STE- global longitudinal strain (GLS) were assessed, being regularly measurable. Strain values < 5th percentile of the control group were considered abnormal. "Suspected" and "confirmed" AM were similar, except for medium time of CMR evaluation (5.2 vs 1 months from presentation, respectively; p = 0.004). Compared to healthy controls, both "suspected" and "confirmed" AM showed significantly impaired strain values. LV-global circumferential strain (GCS), right ventricular GCS and LV-GLS were abnormal in 15.4% and 15.9%, 20.5% and 15.9%, 7.7% and 9.1% in "confirmed" and "suspected" AM, respectively. STE analysis confirmed the results on LV-GLS, however a weak correlation emerged between STE and CMR-FT LV-GLS (p = 0.08). Conclusions: Compared to STE, CMR-FT analysis provided a more comprehensive and complementary biventricular strain evaluation that resulted similar in "confirmed" and "suspected" AM with normal LVEF. Conversely, mostly biventricular GCS was significantly reduced in up to 20% of patients, compared to healthy controls. [ABSTRACT FROM AUTHOR]

We present a retrospective study to evaluate safety and effectiveness of ultrasound (US)-guided tattooing with charcoal of suspicious laterocervical lymph nodes. When an open biopsy of a laterocervical lymph node is needed, the choice of the lymph node to excise and examine is fundamental to avoid rebiopsy. Surgeons tend to choose the most surgical approachable enlarged lymph node that does not always correspond to the one with worst echographic aspect. We present 16 cases of patients with laterocervical adenopathy with inconclusive or non-adequate results at fine needle aspiration cytology addressed to open biopsy. Those patients underwent US-guided preoperative injection of a charcoal suspension inside the lymph node to excise to mark it, and then excisional biopsy was performed. Sixteen marked lesions (100 %) were detected intraoperatively and dissected. The injected charcoal was detected intraoperatively in all cases. In 14 patients (87, 5 %) it was inside the lesion; in two cases (12, 5 %), the charcoal suspension was found in the tissues above the lesion. The procedure was well tolerated in all cases. No major procedure-related complications were encountered. US-guided charcoal tattooing is a new, safe, well-tolerated, and easy-to-perform technique for the marking of US suspicious laterocervical lymph nodes. This preliminary study shows a high technical success rate (76 %) and high percentage of intraoperative detection of marked lesions (100 %) with a low rate of complications. [ABSTRACT FROM AUTHOR]

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Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of La Radiologia Medica is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to report the different findings that can be visualised with virtual angioscopy starting from rotational angiography (RA) and three-dimensional (3D) image processing (3DRA) in the evaluation of the abdominal aorta and iliac arteries. Fifty-seven patients showing an occlusive or aneurysmal disease of the abdominal aorta and iliac arteries underwent intraarterial digital subtraction angiography (DSA) equipped with the RA function and a 3D workstation. We found that 3DRA is able to generate images of the examined vessels with a very effective 3D appearance; furthermore, it is able to create images of the lumen and wall of the vessel through two different modalities: endoviews and cross sections. The possibility of matching high-density structures (i.e. calcified plaques and stents) to standard 3D reconstructions of the examined arteries was applied. Different aspects of the arteries can be demonstrated in the angioscopic elaborations: the normal and stenotic lumen, artery bifurcations, the collateral vessel origins and the severity and extensions of atheromatous calcifications and their relationships to the vessel wall. Virtual angioscopy is able to visualise some devices (catheters, stents) introduced during diagnostic and interventional procedures. The constant technological evolution of diagnostic imaging is offering new image-processing techniques, providing new types of previously unexplored information. We present a summary of the different radiological findings that can be demonstrated with this new imaging technique. [ABSTRACT FROM AUTHOR]

This paper describes the different endovascular treatments (cuffs, endografts and embolisation) available for types I, II and III endoleaks occurring after endovascular abdominal aortic aneurysm repair (EVAR). From January 2000 to June 2006, 134 patients (118 men, 16 women; mean age 75.1 years) underwent EVAR. Ten patients (7%) developed significant endoleaks requiring endovascular treatment. Five endoleaks were type I, two were type II and three were type III. Of the five type I endoleaks, four were proximal and one was distal. The proximal endoleaks were treated by cuff deployment, whereas the distal endoleak was treated with a bifurcated graft. Of the two patients with type II endoleak, one was treated by translumbar puncture and coil embolisation, and the other was treated by superselective embolisation of the lumbar feeding vessel with nonresorbable particles. Of the three patients with type III endoleak, two were treated by deploying an aortouniiliac endograft inside the bifurcated graft and the other by implanting a cuff to restore continuity between the graft body and the contralateral limb. Endovascular treatment was successful in 6/10 cases, whereas three cases required surgical conversion. One patient did not undergo surgery owing to poor general condition. The reported incidence of endoleaks after EVAR is 10%–20%. Significant endoleaks should be treated promptly. Endovascular treatment can be done with different techniques, but success in not constant due to adverse anatomical conditions and technical difficulties. [ABSTRACT FROM AUTHOR]

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). 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 virtual endoluminal views. The lungs were segmented manually from the hilum to the visceral pleura on the axial images, and the entire lung volume was calculated. A histogram was generated representing the fractional volume of tissues, the density of which was within a preset range. A curve was then obtained from the histogram. Native axial images and cine-mode display allowed complete evaluation of lung volumes. Virtual bronchography allowed a better assessment of the distribution of bronchiectasis. Virtual bronchoscopy was limited by the fact that it visualised only the surface, without differentiating mucus from the bronchial wall. Manual segmentation and generation of density-volume curves required 41±7 min for each lung. Three curve patterns were identified depending on disease severity. Volume-density analysis of lungs with CF is feasible. Its main advantage is that image analysis is not analogical, as the assessment is not performed using scoring systems or similar ordinal scales. This technique cannot differentiate acute from chronic findings, and the predictive value of the curve should be assessed. [ABSTRACT FROM AUTHOR]

Diffsion–weighted (Dw) imaging has for a number of years been a diagnostic tool in the field of neuroradiology, yet only since the end of the 1990s, with the introduction of echoplanar imaging (EPI) and the use of sequences capable of performing diffusion studies during a single breath hold, has it found diagnostic applications at the level of the abdomen. The inherent sensitivity to motion and the magnetic susceptibility of Dw sequences nonetheless still create problems in the study of the abdomen due to artefacts caused by the heartbeat and intestinal peristalsis, as well as the presence of various parenchymal–gas interfaces. With regard to focal liver lesions, a review of the literature reveals that Dw imaging is able to differentiate lesions with high water content (cysts and angiomas) from solid lesions. With regard to the latter, although there are differences between benign forms [focal nodular hyperplasia (FNH), adenoma] and malignant forms [metastasis, hepatocellular carcinoma (HCC)] in their apparent diffusion coefficient (ADC) in the average values for histological type, there is a significant overlap in values when lesions are assessed individually, with the consequent problem of their correct identification. One promising aspect is the possibility of quantifying the degree of fibrosis in patients with chronic liver disease and cirrhosis given that the deposit of collagen fibres “restricts” the motion of water molecules and therefore reduces ADC values. However, even in this field, studies can only be considered preliminary and far from real clinical applications. The retroperitoneum is less affected by motion artefacts and similarly deserves the attention of Dw imaging. Here it is possible to differentiate mucin–producing tumours of the pancreas from pseudocystic forms on the basis of ADC values even though the limited spatial resolution of Dw imaging does not enable the identification of small lesions. Dw imaging may be applied to the study of the kidney to differentiate hydronephrosis from pyonephrosis and with regard to tumours, solid from pseudocystic forms. In addition, given that renal parenchyma has significantly variable ADC values on the basis of the anatomic section and physiological conditions, the possibility of assessing functional alterations is currently being studied. Indeed, a good correlation has been found between ADC values and glomerular filtration rate. With regard to musculoskeletal applications, the absence of motion artefacts in the regions studied has enabled the development of sequences less sensitive to magnetic susceptibility and with greater spatial resolution than EPI. Attempts have therefore been made to use Dw imaging in the characterization of soft–tissue tumours although the findings so far have been disputed. Greater agreement has been found regarding sensitivity of the technique in assessing response of these tumours to chemotherapy: tumour necrosis is thought to increase ADC whereas the persistence of vital neoplastic tissue tends to lower it. One of the most promising applications of Dw imaging is without doubt the assessment of vertebral collapse where a high ADC has been shown to be associated with an osteoporotic cause and a low ADC with a neoplastic cause. Nonetheless, even here, a moderate overlap between ADC values of the two types has been encountered. Dw imaging has also been used in the assessment of bone marrow cellularity: areas of tightly packed cells show a higher ADC value than hypocellular areas. In particular, no significant difference in ADC is noted between normal hypercellular bone marrow and hypercellular bone marrow secondary to lymphomatous infiltration whereas this difference is significant between hypocellular, normocellular and haematopoietic hypercellular bone marrow. With regard to the study... [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate cortical activation patterns in patients with Parkinson’s disease during a relatively complex motor task. Seven patients (six men and one woman) with lateralised akinetic-rigid Parkinson’s disease underwent functional magnetic resonance imaging (MRI) of the brain with a 1.5-T magnet. Finger tapping was chosen as a motor task. The control group included 11 volunteers (six men and five women) with no neurological disease. Patients showed hyperactivity of the ipsilateral and contralateral motor cortex associated with bilateral over-activation of the parietal cortex during movement of the affected hand. In some cases, there was a lack of activation of the pre-motor and supplementary motor areas whereas, when present, activation in these areas was greater during movement of the healthy hand. Finally, activation of the occipital cortex was found in all patients as a result of their tendency to control movement visually. Results of this study confirm a re-organisation of cortical circuits due to subcortical damage in patient’s with Parkinson’s disease. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse the costs pertaining to the radiology department of magnetic resonance angiography (MRA) and intra-arterial digital subtraction angiography (DSA) in the evaluation of arterial disease of the lower limbs. The differential cost of the two procedures, i. e. the sum of equipment costs (amortisation and service contract), variable costs (supplies and related services) and personnel costs (radiologist, radiographer and nurse) was determined. The common cost (auxiliary personnel and indirect internal costs) was also calculated. Finally, the full cost of the two procedures was obtained (sum of differential and common costs). The differential cost of MRA was 186.14 euro (equipment costs: 50.80 euro, variable costs: 75.04 euro, personnel costs: 60.30 euro) while the differential cost of intra-arterial DSA was 238.18 euro (equipment costs: 57.60 euro, variable costs: 90.13 euro, staff costs: 90.45 euro). The estimated common cost was 5.62 euro. Therefore, the full cost of MRA was 191.76 euro and the full cost of intra-arterial DSA was 243.80 euro (27.1% higher). Intra-arterial DSA costs more than MRA, mainly because of the higher costs of supplies used during the procedure and higher personnel costs (as a result of the longer duration of intra-arterial DSA). It should be noted that our evaluation considers costs pertaining to the radiology department only. It is evident that an economic analysis considering hospital costs as well would result in much higher costs for DSA if postprocedure hospitalisation is required. Our results cannot be simply exported to other radiology departments since they refer to the technology and organisation adopted in our department. However, our cost analysis model can be easily applied to other environments. MRA provides good diagnostic accuracy in the evaluation of arteries of the lower extremities, and its biological cost is far lower than that of intra-arterial DSA (MRA is noninvasive, it does not use ionising radiation, and the contrast medium is safe). Its lower cost is another argument in favour of the use of MRA instead of intra-arterial DSA in the evaluation of lower-extremity arterial disease. [ABSTRACT FROM AUTHOR]

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). On-site sonologists performed retrospective assessment of contrast-enhancement patterns by consensus. Results: Centripetal fill-in preceded (n = 50) or not preceded (n = 3) by peripheral nodular/rim-like enhancement was the prevalently observed contrast-enhancement pattern, equivalent to the typical enhancement pattern of liver hemangiomas on contrast-enhanced computed tomography or magnetic resonance imaging. In the remaining lesions, additional enhancement patterns (diffuse contrast enhancement with rapid fill-in and a late hyper-isoechoic appearance, n = 6; peripheral nodular enhancement with a late hypoechoic appearance, n = 3; or persistent heterogeneous and hyperechoic appearance, n = 3) were observed. Conclusion: Different contrast-enhancement patterns are possible in atypical liver hemangiomas after microbubble injection. Typical centripetal fill-in is the prevalent pattern and its evidence allows diagnosis. [ABSTRACT FROM AUTHOR]

Nowadays, the surgical treatment of male-to-female transsexuals is not rare, but few studies have reported on postoperative results. The aim of this study was to determine the role of magnetic resonance imaging (MRI) in the evaluation of the results of sex reassignment surgery (SRS) in male-to-female transsexual patients. Ten such patients (median age 28 years, range 21-47), who had undergone SRS using an inversion of combined penile and scrotal skin flaps for vaginoplasty, were examined with MRI after the operation. Turbo spin-echo T2-weighted and spin-echo T1-weighted images were obtained on sagittal, coronal, and axial planes with a 1.5 T superconducting magnet. The images were acquired on the sagittal, coronal and axial planes, by using TSE T2 weighted and SG T1 weighted images. MRI was performed within 2 weeks after the operation in six patients and after 1 year in the other four. In all cases, the images were obtained with and without an inflatable silicon vaginal tutor. The average neovaginal depth was 7.9 cm (range 6-10 cm). In four patients, MRI showed the presence of cavernosal rests, and in two there were remnants of the corpus spongiosus. In another patient, an abnormal anterior inclination of the neovagina was present. The average distance of the recto-vaginal septum was 4 mm (range 3-6 mm). No major complications were noted. Our study allowed not only a detailed assessment of the pelvic anatomy after genital reconfiguration, but also provided valuable information on possible complications. [ABSTRACT FROM AUTHOR]

Background: We investigated the value of magnetic resonance imaging (MRI) in the evaluation of sex-reassignment surgery in male-to-female transsexual patients.Methods: Ten male-to-female transsexual patients who underwent sex-reassignment surgery with inversion of combined penile and scrotal skin flaps for vaginoplasty were examined after surgery with MRI. Turbo spin-echo T2-weighted and spin-echo T1-weighted images were obtained in sagittal, coronal, and axial planes with a 1.5-T superconductive magnet. Images were acquired with and without an inflatable silicon vaginal tutor. The following parameters were evaluated: neovaginal depth, neovaginal inclination in the sagittal plane, presence of remnants of the corpus spongiosum and corpora cavernosa, and thickness of the rectovaginal septum.Results: The average neovaginal depth was 7.9 cm (range = 5-10 cm). The neovagina had a correct oblique inclination in the sagittal plane in four patients, no inclination in five, and an incorrect inclination in one. In seven patients, MRI showed remnants of the corpora cavernosa and/or of the corpus spongiosum; in three patients, no remnants were detected. The average thickness of the rectovaginal septum was 4 mm (range = 3-6 mm).Conclusion: MRI allows a detailed assessment of the pelvic anatomy after genital reconfiguration and provides information that can help the surgeon to adopt the most correct surgical approach. [ABSTRACT FROM AUTHOR]

Non-ionic dimers induce less diuresis than non-ionic monomers, resulting in increased opacification of the urinary tract in intravenous urography. This trial compared the diagnostic efficacy of iodixanol and iopromide in patients with macroscopic haematuria. One hundred consecutive patients with normal renal function and macroscopic haematuria entered a double blind, comparative, randomised, parallel trial. Contrast media were given with bolus injection in doses of 300 mgI/kg b.w. Radiographs were blindly evaluated by three radiologists who analysed different parameters (calyceal density and filling, papillary blush detection, delineation of collecting ducts, renal pelvis opacification, visualisation of ureters, bladder density, bladder distention) and estimated the diagnostic confidence (whether abnormal findings were definitely absent, probably absent, doubtful, probably present or certainly present). Radiological diagnoses were compared with final diagnoses. Results were summarised as the ratio of the odds of having a worse performance of iopromide vs iodixanol. Iodixanol showed a significantly better calyceal density and filling [odds ratio (OR): 1.96; 95% confidence interval (CI): 1.60-2.41], a significantly better pelvis opacification (OR 2.91; CI 2.02-4.18) and a significantly more frequent papillary blush detection (OR 1.95; CI 1.29-2.95). Iopromide showed a significantly better ureteral visualisation (OR 0.67; CI 0.48-0.92) and a significantly higher bladder distention (OR 0.59; CI 0.36-0.99). Iodixanol allowed a significantly higher diagnostic confidence as to calyceal evaluation (OR 1.35; CI 1.01-1.79). No significant differences were found with regard to other parameters. The results confirmed theoretical expectations. The higher opacification provided by iodixanol allowed better results and a higher diagnostic confidence in the upper excretory pathway. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the potential of projection-reconstruction (PR) MR microscopy in the accurate measurement of cartilage thickness. Short-TE PR microimages were acquired at 7.05 T on bone-cartilage cylindrical plugs excised from four regions of two disarticulated femoral heads (i. e. superior, inferior, posterior and anterior), using an NMR instrument equipped with a microimaging accessory. The PR microimages were then correlated with conventional spin-echo (SE) microimages and with histology. On PR microimages, acquired with an echo time of 3.2 ms, the cartilage signal was increased, allowing an accurate delineation of the cartilage from the tidemark/cortical bone region. As a consequence, by the PR method a more precise measurement of cartilage thickness compared with that performed by the conventional SE approach was feasible. An excellent correlation between PR microimages and histology was also obtained (r = 0.90). By the proposed method it is possible to accurately determine the cartilage thickness better than with the conventional SE sequences. [ABSTRACT FROM AUTHOR]

We examined the value of dynamic magnetic resonance imaging (MRI) in chronic renal disease with renal insufficiency. In 33 consecutive patients (21 vascular nephropathy, 12 glomerular nephropathy) MRI was performed using a 1.5-T unit and a body coil, with SE T1-weighted (TR/TE = 600/19 ms) and dynamic TFFE T1-weighted sequences (TR/TE = 12/5 ms, flip angle = 25 degrees ) after manual bolus injection (via a cubital vein) of 0.1 mmol/kg Gd-DTPA-BMA. Morphological evaluation was performed in unblinded fashion by three radiologists, evaluating renal size, cortical thickness, and corticomedullary differentiation. Functional analysis was performed by one reviewer. Time-signal intensity curves, peak intensity value (P), time to peak intensity (T), and the P/T ratio were obtained at the cortex, medulla, and pyelocaliceal system of each kidney. The relationship of these parameters to serum creatinine and with creatinine clearance was investigated. A good correlation between morphological features of the kidneys and serum creatinine values was found. Morphological findings could not distinguish between vascular and glomerular nephropathies. A statistically significant correlation (P <0.01) between cortical P, cortical P/T, medullary P, and serum creatinine and creatinine clearance was found. A significant correlation (P <0.01) was also found between cortical T, medullary P/T, T of the excretory system, and creatinine clearance. The cortical T value was significantly higher (P <0.01) in vascular nephropathy than in glomerular nephropathy. Thus in patients with chronic renal failure dynamic MRI shows both morphological and functional changes. Morphological changes are correlated with the degree of renal insufficiency and not with the type of nephropathy; the functional changes seem to differ in vascular from glomerular nephropathies. [ABSTRACT FROM AUTHOR]

The aims of this study were (a) to compare the MR appearance of normal articular cartilage in ex vivo MR imaging (MRI) and MR microscopy (MRM) images of disarticulated human femoral heads, (b) to evaluate by MRM the topographic variations in articular cartilage of disarticulated human femoral heads, and subsequently, (c) to compare MRM images with histology. Ten disarticulated femoral heads were examined. Magnetic resonance images were obtained using spin-echo (SE) and gradient-echo (GE) sequences. Microimages were acquired on cartilage-bone cylindrical plugs excised from four regions (superior, inferior, anterior, posterior) of one femoral head, using a modified SE sequence. Both MRI and MRM images were obtained before and after a 90 degrees rotation of the specimen, around the axis perpendicular to the examined cartilage surface. Finally, MRM images were correlated with histology. A trilaminar appearance of articular cartilage was observed with MRI and with a greater detail with MRM. A good correlation between MRI and MRM features was demonstrated. Both MRI and MRM showed a loss of the trilaminar cartilage appearance after specimen rotation, with greater evidence on MRM images. Cartilage excised from the four regions of the femoral head showed a different thickness, being thickest in the samples excised from the superior site. The MRM technique confirms the trilaminar MRI appearance of human articular cartilage, showing good correlation with histology. The loss of the trilaminar appearance of articular cartilage induced by specimen rotation suggests that this feature is partially related to the collagen-fiber orientation within the different layers. The MRM technique also shows topographic variations in thickness of human articular cartilage. [ABSTRACT FROM AUTHOR]

The efficacy and safety of nonionic dimeric contrast media in subjects with impaired renal function is largely unknown. The present study was aimed at determining the risk of tubular nephrotoxicity in patients with mild to moderate renal insufficiency who underwent intravenous urography (IVU) with the nonionic dimeric contrast agent iodixanol (Visipaque, Nycomed Imaging, Oslo, Norway). In a double-blind protocol 64 patients (55 males; mean age 68.3 years) with serum creatinine between 135 and 265 micromol/l who were to undergo IVU were randomized to receive iodixanol (a nonionic dimer) or iopromide (a nonionic monomer), 600 mg I/kg b. w. Renal function was evaluated before and 1 h, 6 h, 24 h, 48 h and 7 days after IVU with analysis of serum creatinine, urinary enzymes alanylaminopeptidase and N-acetyl-beta-glucosaminidase, and urinary microproteins alpha-1-microglobulin and albumin. Renal function remained stable in both contrast medium groups during the follow-up period. No statistically significant differences were observed between the monomer and the dimer in terms of urinary enzyme and microprotein excretion or serum creatinine. Transient radiocontrast-induced nephropathy developed in 1 patient who had received iodixanol. The administration of the nonionic dimeric contrast medium iodixanol, or of the nonionic monomer iopromide, entailed a low nephrotoxic potential in patients with mild to moderate renal insufficiency undergoing excretory urography. [ABSTRACT FROM AUTHOR]

Twenty-six patients with a clinical diagnosis of spondylodiscitis were examined with non-contrast and contrast-enhanced MRI in order to define the contribution of gadolinium-DTPA (Gd-DTPA) and different pulse sequences, including a fat suppression sequence (SPIR). Spin echo (SE) T1-weighted images before and after Gd-DTPA injection and SE T2-weighted images were obtained in all patients. Twelve patients were also examined using the SPIR sequence following Gd-DTPA injection. Signal intensity and morphological features of the disc and vertebral lesions were then evaluated. The SE T1-weighted sequence with Gd-DTPA was very effective in showing the pathological changes at the level of the disc as an area of low signal intensity surrounded by a peripheral rim of enhancement in 24 of 26 cases (92%). This feature was not visible on non-enhanced images. As regards contiguous vertebral lesions this sequence was less informative, since in 8 of 26 cases (31%) the vertebral lesions became isointense and therefore not detectable. In 12 cases there was extension into the surrounding structures (spinal canal and/or paravertebral tissues). An enhanced SE T1-weighted sequence provided good anatomical definition of the extension of the infection in the spinal canal in all cases with this type of involvement (7 of 12). Regarding the 7 cases with paravertebral extension, no extension was visible in 1 case due to the reduced contrast with the surrounding fat following Gd-DTPA injection. The enhanced SPIR sequence was very effective, particularly in detecting the lesions in the vertebral bodies, avoiding the limitation of the enhanced SE T1-weighted sequence. The SPIR sequence was also effective in showing the extension within the spinal canal and the paravertebral fat. On the basis of our results the combination of a SE T1-weighted sequence without contrast and SPIR sequence with Gd-DTPA seems to be the best approach in cases of spondylodiscitis. [ABSTRACT FROM AUTHOR]

Meningeal cysts (MC) are rare extensions of the meninges and are diverticula of the spinal meningeal sac, nerve root sheath or arachnoid that contain cerebrospinal fluid (CSF). They communicate with the subarachnoid space (SAS). The aim of this study was to demonstrate the MRI findings and to emphasise the contribution of MRI to the diagnosis of this rare pathology. MRI findings were evaluated according to a new classification that divides MCs into extradural cysts without (type 1) or with (type 2) spinal nerve root fibres and intradural cysts (type 3). Because of its high contrast resolution MRI can distinguish the three types of MC. The use of the different levels of signal intensity of the cyst and CSF in T2-weighted images to distinguish communicating from non-communicating MCs is illustrated. This diagnostic sign exploitats the signal loss due to flow phenomena of CSF pulsations on ungated sequences to reveal the communication of the MC with the SAS. We recommend MRI as the most sensitive and specific modality for the study of MCs. [ABSTRACT FROM AUTHOR]

Computed tomography (CT) and magnetic resonance (MR) findings in two patients with Fahr disease are presented. The CT scan showed extensive high attenuation foci with an almost symmetrical distribution in the dentate nuclei of the cerebellum, pons, basal ganglia and white matter. MR signals of the high attenuation CT foci ranged from hyperintensity to hypointensity. A hypothetical model for CT and MR signals is proposed, based upon the chemical composition of the deposits in Fahr disease. In the authors opinion the term mineralisation is more appropriate for this disease. A pattern of the location and distribution of the mineral ions that participate in this disease is proposed and a functional evaluation of the brain tissue has been estimated. A predictive pattern for the further evolution of the disease is proposed. [ABSTRACT FROM AUTHOR]

Objectives: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Materials and methods: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Results: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Conclusion: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Clinical relevance statement: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.Key Points: To investigate preoperative MRI evaluation of the features of the mylohyoid muscle (MM) predictive of its infiltration in oral squamous cell carcinoma (OSCC) treatment planning, defining the most appropriate sequences to study its deep extension into the floor of the mouth (FOM).We applied a 7-point score to retrospectively evaluate preoperative imaging of patients who underwent surgery for OSCC over 11 years. The results were compared with histopathological findings using Spearman’s rank coefficient. Receiver operating characteristic curves were employed to assess the score’s ability to predict MM infiltration, determining optimal thresholds for sensitivity, specificity, and predictive values. The Mann–Whitney U-test confirmed that infiltration judgments did not overlap around this threshold. Cohen’s K statistical coefficient was used to evaluate the interobserver agreement.Fifty-two patients (mean age 66.4 ± 11.9 years, 36 men) were evaluated. Histopathological examination found MM infiltration in 21% of cases (n = 11), with 90% classified in the highest Score categories. A score > 4 proved to be the best cut-off for predicting the risk of MM infiltration, with a sensitivity of 91% (CI: 0.57–0.99), specificity 61% (CI: 0.45–0.76), PPV 38% (CI: 0.21–0.59), and NPV 96% (CI: 0.78–0.99). At the subsequent single-sequence assessment, the TSE-T2wi had the highest diagnostic accuracy, with sensitivity 90% (CI: 0.57–0.99), specificity 70% (CI: 0.53–0.82), PPV 45% (CI: 0.25–0.67), and NPV 96% (CI: 0.80–0.99).The 7-point score is a promising predictor of safe surgical margins for MM in OSCC treatment, with the particular benefit of T2-weighted sequences.Our scoring system for tumor infiltration of MM, which is easy to use even for less experienced radiologists, allows for uniformity in radiological language, thereby ensuring crucial preoperative information for the surgeon.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor.The relationship of the MM to an oral lesion may impact surgical planning.As the score increases, there is a greater incidence of infiltration in the MM.Our score system improves radiologists’ reporting for MM involvement by tumor. [ABSTRACT FROM AUTHOR]