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Purpose  The purpose of this study was to evaluate the effect of correction of abnormal radiographic parameters on postoperative pain in a group of patients treated arthroscopically for femoracetabular impingement (FAI). Methods  A retrospective study was performed on 23 patients affected by mixed-type FAI and treated arthroscopically. There were 11 males and 12 females with a mean age of 46.5 (range: 28-67) years. Center-edge (CE) and α angles were measured on preoperative and postoperative radiographic and magnetic resonance imaging (MRI) studies and were correlated with persistent pain at follow-up. Results  The mean preoperative CE and α angles were 38.6 ± 5.2 and 67.3 ± 7.2 degrees, respectively. At follow-up, in the 17 pain-free patients, the mean pre- and postoperative CE angle were 38.1 ± 5.6 and 32.6 ± 4.8 degrees, respectively, whereas the mean pre- and postoperative α angles at MRI were 66.3 ± 7.9 and 47.9 ± 8.9 degrees, respectively. In six patients with persistent hip pain, the mean pre- and postoperative CE angles were 39.8 ± 3.6 and 35.8 ± 3.1 degrees, respectively, whereas the mean pre- and postoperative α angles were 70.0 ± 3.9 and 58.8 ± 2.6 degrees, respectively. Mean values of all the analyzed radiological parameters, except CE angle in patients with pain, improved significantly after surgery. On comparing patient groups, significantly lower postoperative α angles and lower CE angle were observed in patients without pain. Conclusion  In case of persistent pain after arthroscopic treatment of FAI, a new set of imaging studies must be performed because pain may be related to an insufficient correction of preoperative radiographic abnormalities. Level of Evidence  Level IV, retrospective case series.

Background: Patients with low back pain frequently demonstrate recumbent magnetic resonance imaging (MRI) alterations not always related to homogeneous clinical symptoms. The purpose of this study was to evaluate and quantify the statistical significance of variations of some anatomical parameters of the lumbosacral spine and reveal occult disc pathologies from recumbent to upright position in patients with acute and chronic low back pain., Materials and Methods: Fifty-seven patients complaining of low back pain (27 women, 30 men) underwent dynamic lumbosacral MRI with a 0.25-T tilting system (G-scan Esaote). We settled five parameters for which variations have been evaluated: lumbosacral angle, lordosis angle, L3-L4 intersomatic disc height, L3-L4 interspinous processes distance, and widest anteroposterior dural sac diameter. Images were obtained in both recumbent and upright positions., Results: Statistically significant differences [one-way analysis of variance (ANOVA), p = 0.0043] were found between each pair of values of parameters sampled in recumbent and upright positions. In 70 % of patients, on visual qualitative analysis only, an increment of disc protrusions and/or spondylolisthesis was found in the upright position; in three cases, in the upright position only, an interarticular pseudocyst was found., Conclusions: Dynamic MRI with an open-configuration, low-field tilting MRI system is a feasible and promising tool to study degenerative pathology of the spine. Moreover, in cases of low back pain with negative MRI in the recumbent position or in patients with pain in the upright position only, tilting MRI permits visualization of occult spine and disc pathologies in patients with acute or chronic low back pain.

With our study we wanted to compare the diagnostic accuracy of conventional radiography (orthopanoramic and intraoral radiography) and Cone Beam CT (CBCT) for the diagnosis of periapical lesions on the posterior elements of the upper maxilla endodontically treated.The images were analyzed by a radiologist and an endodontist whose interpretation of radiological examinations is unique. Were examined 34 molars (23 first molars and 13 second molars) with a total of 102 roots. The CBCT detected a significantly higher number of lesions (43%, p <0.001) compared to conventional radiography. Our results demonstrate that the CBCT can be inserted into the diagnostic routine for the evaluation of all pre-prosthetic posterior elements of the upper jaw endodontically treated in addition to the diagnostic techniques 2D, especially when in the treatment plan is provided the realization of an abutment. The CBCT, which has reduction of cost and absorption of radiation with respect to the conventional CT, is also very useful even when there is a need to perform a surgical treatment-endodontic (apicectomy) of a lesion diagnosed with 2D techniques.

TO CORRELATE DIFFERENT CT SYSTEM: MSCT (multislice computed tomography) with different acquisition parameters (100KV, 80KV), different reconstruction algorithm (ASIR) and CBCT (cone beam computed tomography) examination in terms of absorbed X-ray dose and diagnostic accuracy.80 KV protocols compared with 100 KV protocols resulted in reduced total radiation dose without relevant loss of diagnostic image information and quality. CBCT protocols compared with 80 KV MSCT protocols resulted in reduced total radiation dose but loss of diagnostic image information and quality although no so relevant.In addition the new system applies to equipment ASIR applicable on MSCT allows 50% of the dose without compromising image quality.

Aim: The aim of the study is to evaluate the incidence of different expansive lesions and the advantages of the clinical employment of Dentalscan to study bones lesions and to establish a common diagnostic path., Materials and Methods: Since January 2005 to November 2009, 3200 patients, not selected for sex or age, have undergone a CT "Dentalscan" in the department of Diagnostic Imaging, Tor Vergata University Hospital (PTV), a suspect bone pathology was found in 704 of them through the XR-orthopantomograpy (OPT). CT images were obtained with General Electric CT Light Speed multislice. Images were saved in the Advantage Workstation (GE) supported by the "Dentascan" dedicated software and by the 3D software (3D SSD). The protocol was : Slice thickness 1,25 mm, gap 0, matrix 512 × 512, 140 KV and 70 mA. All the lesions were also studied with the dedicated three-dimensional reconstructor 3D SSD. Biopsy for diagnosis was performed on all the lesions, except one (false positive with digital OPT). THE TECHNIQUE SENSITIVITY WAS ASSESSED FOR TWO IMPORTANT CLASSES: benign and malignant lesions., Results: Through CT Dentascan a detailed evaluation of the jaws lesions and their extension was obtained. 656 patients (93.1 %) out of 704 examined for a suspicious lesion on the orthopantomography had a benign lesion: (127 follicular cysts (18.2 %), 181 radicular cysts (25.1%), 93 non odontogenic cysts (13.2%), 29 fibroma (4.2%), 198 odontomes (28.2%), 24 ameloblastoma (3.6%), 4 brown tumors (0.7%), 47 (6.9%) had malignant lesions: (12 carcinoma (1.7%), 29 metastasis (4.3%), 6 sarcoma (0.8%), 1 Dentascan CT resulted to be negative (1 false positive of digital OPT). The sensitivity of the technique for both groups was 99% for benign lesions and 98% for malign lesions., Conclusions: CT Dentascan characteristics suggest to consider these techniques as the gold standard for the evaluation of jaw expansive lesions and the support of surgical planning.

Objective: To determine by low-dose computed tomography (CT) protocol the dental and periodontal effects of rapid maxillary expansion (RME)., Materials and Methods: The sample comprised 17 subjects (7 males and 10 females), with a mean age at first observation of 11.2 years. Each patient underwent expansion of 7 mm. Multislice CT scans were taken before rapid palatal expansion (T0), at the end of the active expansion phase (T1), and after a retention period of 6 months (T2). On scanned images, measurements were performed at the dental and periodontal levels. Mean differences between measurements at T0, T1, and T2 were examined through analysis of variance (ANOVA) for repeated measures with post-hoc tests., Results: All interdental transverse measurements were significantly increased at both T1 and T2 with respect to T0. In the evaluation of T0-T1 changes, periodontal measurements were significant on the buccal aspect of banded teeth with a reduction in alveolar bone thickness corresponding to the mesial (-0.5 mm; P < .05) and distal (-0.4 mm; P < .05) roots of the right first molar and to the mesial root of the left first molar (-0.3 mm; P < .05). In the evaluation of overall T0-T2 changes, the lingual bone plate thickness of both first molars was found to be significantly increased (+0.6 mm; P < .05)., Conclusions: RME therapy induces a significant increase in the transverse dimension of the maxillary arch in growing subjects without causing permanent injury to the periodontal bony support of anchoring teeth discernible on CT imaging.

Aim: The aim of this study was to apply low-dose CT scans to evaluate the treatment and post-retention effects of RME on nasal cavity and periodontal effects., Materials and Methods: CT scans of 17 subjects (7 males 10 females, mean age 11.2 years) were taken before RME (T0), at the end of the expansion phase (T1), and after a retention period of 6 months (T2). Measurements were performed on axial scans and on 3 different coronal scans. Statistical analysis was performed with ANOVA for repeated measures with post-hoc tests., Results: Transverse dimensions of nasal cavity showed statistically significant T0-T1 increments at all the 3 coronal scans. All T0-T1 increments at the nasal levels showed a decrease in magnitude from the anterior to the posterior measurements. In the evaluation of T0-T1 changes, periodontal measurements were significant on the buccal aspect of banded teeth with a reduction in alveolar bone thickness. In the evaluation of T0-T2 changes, the lingual bone plate thickness resulted significantly increased., Conclusions: RME therapy induces a significant increase in the transverse dimension of the nasal cavity without permanent injuries to the periodontal bony support discernible at CT imaging. After six months the expansion of the nasal cavity results stable.

The aim of this study is to describe the current role of imaging in pre-surgical planning, reporting 25 cases of paranasal sinus tumors examined in our Institute. Between June 2006 and May 2008, we identified 25 patients with malignant tumors of the paranasal sinuses. All of the patients were evaluated with CT and/or MR exams. US were used to assess regional lymph node involvement. When necessary CT-PET scanning using FDG, was done. Diagnostic imaging is essential during the initial work-up of a patient suspected of having a paranasal sinus tumor. The role of imaging is to define the tumor extension, nodal involvement, metastases and recurrences in the postoperative patient. CT and MR imaging are the primary modalities employed; each have advantages and disadvantages but tend to be complementary. The involvement of fine bone structures is best evaluated with CT. In assessing the extent of the tumor, MR provides excellent soft tissue detail, allowing for delineation of neoplasm from surrounding inflammatory tissue and secretions. For evaluation of lymph node enlargement color-Doppler US, CT and MR provide morphologic data, while CT-PET provides metabolic data. CT-PET can be used to stage nodal and metastatic disease and for assessing the efficacy of therapy or recurrent disease.

Objective: compare the values of the Bennett angle measured by an average value articulator with the ones measured by a 64 slices Computed Tomography (CT)., Methods: we have studied a patient aged 72. Maxillary and mandibular impressions were obtained from the patient and placed on the average value articulator using wax-ups and a facial arch in order to perform the Bennett angle measurations by such device. CT measurements were carried out using templates in order to block the Patient in the correct mandibular position., Results: our study has demonstrated that the measurements of the Bennett angle obtained with the average value articulator are consistent with the ones obtained with the 64 slices CT., Conclusions: CT scanning is a useful method, alternative to conventional procedures, as the average value articulator for Bennett angle measurements, and it could become an important diagnostic tool in the gnathological and rehabilitative area.