474 results on '"Brunese L"'
Search Results
152. Split-Bolus Single-Pass Multidetector-Row CT Protocol for Diagnosis of Acute Pulmonary Embolism
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Irene Piscioli, Luisa Pierotti, Alberto Rebonato, Michele Scialpi, Lucio Bellantonio, Lucio Cagini, Alfredo D’Andrea, Antonio Rotondo, Luca Brunese, Scialpi, M, Rebonato, A, Cagini, L, Brunese, L, Piscioli, I, Pierotti, L, Bellantonio, L, D'Andrea, A, and Rotondo, Antonio
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medicine.medical_specialty ,Contrast material ,Pulmonary arteries ,Pulmonary embolisms ,X-Ray computed tomography ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Bolus (medicine) ,Chest Imaging ,Nuclear Medicine and Imaging ,medicine.artery ,medicine ,Pulmonary angiography ,Radiology, Nuclear Medicine and imaging ,Radiology, Nuclear Medicine and Imaging ,business.industry ,Left pulmonary artery ,medicine.disease ,Right pulmonary artery ,Pulmonary embolism ,Embolism ,030220 oncology & carcinogenesis ,Pulmonary artery ,cardiovascular system ,Radiology ,business ,Left Pulmonary Vein - Abstract
Background Currently computed tomography pulmonary angiography (CTPA) has become a widely accepted clinical tool in the diagnosis of acute pulmonary embolism (PE). Objectives To report split-bolus single-pass 64-multidetector-row CT (MDCT) protocol for diagnosis of PE. Patients and methods MDCT split-bolus results in 40 patients suspicious of PE were analyzed in terms of image quality of target pulmonary vessels (TPVs) and occurrence and severity of flow-related artifact, flow-related artifact, false filling defect of the pulmonary veins and beam hardening streak artifacts. Dose radiation to patients was calculated. Results MDCT split-bolus protocol allowed diagnostic images of high quality in all cases. Diagnosis of PE was obtained in 22 of 40 patients. Mean attenuation for target vessels was higher than 250 HU all cases: 361 ± 98 HU in pulmonary artery trunk (PAT); 339 ± 93 HU in right pulmonary artery (RPA); 334 ± 100 HU in left pulmonary artery (LPA). Adequate enhancement was obtained in the right atrium (RA):292 ± 83 HU; right pulmonary vein (RPV): 302 ± 91 HU, and left pulmonary vein (LPV): 291 ± 83 HU. The flow related artifacts and the beam hardening streak artifacts have been detected respectively in 4 and 25 patients. No false filling defect of the pulmonary veins was revealed. Conclusion MDCT split-bolus technique by simultaneous opacification of pulmonary arteries and veins represents an accurate technique for diagnosis of acute PE, removes the false filling defects of the pulmonary veins, and reduces flow related artifacts.
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- 2016
153. Diagnostic value of computed tomography colonography (CTC) after incomplete optical colonoscopy
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Nicola Maggialetti, Claudia Lucia Piccolo, M. D'Innocenzo, Carbone M, M. Zappia, Raffaella Capasso, D. Pinto, Alfonso Reginelli, Luca Brunese, A. Laporta, S. Schipani, Maggialetti, N, Capasso, R., Pinto, D., Carbone, M., Laporta, A., Schipani, S., Piccolo, C. L., Zappia, M., Reginelli, Alfonso, D'Innocenzo, M., and Brunese, L.
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Adult ,Male ,medicine.medical_specialty ,Abdominal pain ,Supine position ,Virtual colonoscopy ,Sedation ,Extracolonic findings ,030218 nuclear medicine & medical imaging ,Optical colonoscopy ,03 medical and health sciences ,Colonic Diseases ,0302 clinical medicine ,Computed Tomography Colonography ,CT colonography ,medicine ,80 and over ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,General Medicine ,Colonography ,Colonoscopy ,Middle Aged ,CTC ,Extracolonic finding ,digestive system diseases ,Prone position ,Contrast medium ,030220 oncology & carcinogenesis ,Colorectal Neoplasms ,Female ,Colonography, Computed Tomographic ,Surgery ,Radiology ,medicine.symptom ,business ,Computed Tomographic - Abstract
Introduction This study evaluated the role of computed tomography colonography (CTC) in patients who previously underwent incomplete optical colonoscopy (OC). We analyzed the impact of colonic lesions in intestinal segments not studied by OC and extracolonic findings in these patients. Methods Between January 2014 and May 2015, 61 patients with a history of abdominal pain and incomplete OC examination were studied by CTC. CTCs were performed by 320-row CT scan in both the supine and the prone position, without intravenous administration of contrast medium. In all patients both colonic findings and extracolonic findings were evaluated. Results Among the study group, 24 CTC examinations were negative for both colonic and extracolonic findings while 6 examinations revealed the presence of both colonic and extracolonic findings. In 24 patients CTC depicted colonic anomalies without extracolonic ones, while in 7 patients it showed extracolonic findings without colonic ones. Discussion CTC is a noninvasive imaging technique with the advantages of high diagnostic performance, rapid data acquisition, minimal patient discomfort, lack of need for sedation, and virtually no recovery time. CTC accurately allows the evaluation of the nonvisualized part of the colon after incomplete OC and has the distinct advantage to detect clinically important extracolonic findings in patients with incomplete OC potentially explaining the patient's symptoms and conditioning their therapeutic management. Conclusion CTC accurately allows the assessment of both colonic and extracolonic pathologies representing a useful diagnostic tool in patients for whom complete OC is not achievable.
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- 2016
154. MR Imaging in Diagnosis of Pelvic Floor Descent: Supine versus Sitting Position
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Antonio Brillantino, L. Monaco, Aniello Iacomino, Luca Brunese, Adolfo Renzi, Beatrice Feragalli, Nicola Serra, Francesca Iacobellis, Salvatore Cappabianca, Iacobellis, F, Brillantino, A, Renzi, A, Monaco, Lucia, Serra, Nicola, Feragalli, B, Iacomino, A, Brunese, L, and Cappabianca, Salvatore
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medicine.medical_specialty ,Supine position ,Article Subject ,Sitting ,Hepatology ,Gastroenterology ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,mental disorders ,medicine ,lcsh:RC799-869 ,Pelvic floor ,business.industry ,Mr imaging ,Surgery ,body regions ,Position (obstetrics) ,medicine.anatomical_structure ,030220 oncology & carcinogenesis ,Vagina ,Defecation ,lcsh:Diseases of the digestive system. Gastroenterology ,Descent (aeronautics) ,Nuclear medicine ,business ,Research Article - Abstract
Introduction. Functional disorders of the pelvic floor represent have a significant impact on the quality of life. The advent of open-configuration systems allowed for the evaluation of defecation with MR imaging in sitting position. The purpose of the present study is to compare the results of static and dynamic pelvic MR performed in supine position versus sitting position, using a new MR prototype machine, in the diagnosis of pelvic floor descent.Materials and Methods. Thirty-one patients with pelvic floor disorders were enrolled, and underwent MR Defecography in supine position with 1.5 T closed magnet (MAGNETOM Symphony, Siemens, Germany) and in sitting position with a 0.25-Tesla open magnet system (G-Scan ESAOTE, Italy).Results. In rest and squeezing phases, positions of bladder, vagina, and ARJ were significantly different when the patient was imaged in supine versus sitting position. In the defecation phase, a significant difference for the bladder and vagina position was detected between the two exams whereas a significant difference for the ARJ was not found. A statistically significant difference exists when the pelvic floor descent is evaluated in sitting versus supine position.Conclusion. Our results show that MR Defecography in sitting position may represent a useful tool to correctly diagnose and grade the pelvic organ descent.
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- 2016
155. A 4-year-old child presenting morning onset of spontaneous tracheal rupture due to bronchial mucous plug occlusion during the nighttime sleep: a case report
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Raffaele Zeccolini, Antonio Rotondo, Alfonso Reginelli, Eugenio Rossi, Massimo Zeccolini, Luca Brunese, Carbone M, Raffaella Capasso, Rosanna Mamone, Capasso, R, Carbone, M, Rossi, E, Mamone, R, Zeccolini, R, Reginelli, Alfonso, Zeccolini, M, Brunese, L, and Rotondo, Antonio
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Male ,Thoracic ,Atelectasis ,Case Report ,Chest pain ,0302 clinical medicine ,Bronchoscopy ,Medicine ,Pneumomediastinum ,Child ,Tomography ,Mediastinal Emphysema ,Medicine(all) ,Tracheal Diseases ,medicine.diagnostic_test ,Medicine (all) ,General Medicine ,respiratory system ,Mucous plug ,X-Ray Computed ,medicine.anatomical_structure ,Anesthesia ,Child, Preschool ,Radiography, Thoracic ,medicine.symptom ,Tracheal rupture ,Cough reflex ,Airway Obstruction ,Bronchial Diseases ,Humans ,Mucus ,Pulmonary Atelectasis ,Rupture, Spontaneous ,Tomography, X-Ray Computed ,medicine.medical_specialty ,03 medical and health sciences ,030225 pediatrics ,Preschool ,Asthma ,Rupture ,Lung ,business.industry ,Spontaneous ,medicine.disease ,Surgery ,respiratory tract diseases ,Radiography ,030228 respiratory system ,Reflex ,business - Abstract
Background Coughing is the most efficient mechanism for clearing mucus and fluid secretions from the airways and its reflex can be suppressed by sleep. Spontaneous tracheal ruptures are believed to result from raised intratracheal pressure against a closed glottis, such as for severe coughing. This is the first reported case of tracheal rupture presented on morning awakening after bronchial mucous plug formation during the nighttime sleep because of an ineffective cough reflex. Case presentation An otherwise healthy white 4-year-old child presented morning onset of dyspnea, chest pain and diffuse swelling of the neck. His history was significant only for nonsevere coughing episodes before his nighttime rest; the child’s parents denied any recent fever, weight loss, pains, trauma, bronchial asthma, and sick contacts. A chest X-ray and computed tomography scan revealed pneumomediastinum, obstructive atelectasis of the lower lobe of his left lung, and a small tracheal laceration confirmed by an emergency bronchoscopy. After endoscopic removal of a mucous plug and secretions, the child’s pulmonary gas exchange and respiratory rate improved, so our patient was managed conservatively. Conclusions This report illustrates an unusual presentation of lung obstructive atelectasis due to a mucous plug manifested by tracheal rupture. This report also highlights the importance of the coughing reflex as one of several defensive mechanisms protecting the airways from the potentially damaging effects of aspirate and accumulated secretions.
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- 2015
156. Small (≤2 cm) atypical hepatic haemangiomas in the non-cirrhotic patient: pattern-based classification scheme for enhancement at triple-phase helical CT
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Irene Piscioli, Maria Antonietta Mazzei, Salvatore Cappabianca, Francesco Barberini, Luca Brunese, Luca Volterrani, Michele Scialpi, Luciano Lupattelli, Scialpi, M, Volterrani, L, Mazzei, Ma, Cappabianca, Salvatore, Barberini, F, Piscioli, I, Brunese, L, and Lupattelli, L.
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Adult ,Male ,medicine.medical_specialty ,Helical computed tomography ,Iohexol ,Contrast Media ,Classification scheme ,Diagnosis, Differential ,Triiodobenzoic Acids ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Aged ,Retrospective Studies ,Neuroradiology ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Ultrasound ,Reproducibility of Results ,Interventional radiology ,Cirrhotic patient ,General Medicine ,Middle Aged ,Image Enhancement ,Helical ct ,body regions ,Liver ,Female ,Radiology ,Hemangioma ,business ,Nuclear medicine ,Tomography, Spiral Computed - Abstract
The aim of this study was to determine by triplephase helical computed tomography (CT) the appearance of atypical small (or = 2 cm) hepatic haemangiomas (HHs) in the non-cirrhotic patient.We retrospectively reviewed the hepatic arterial-dominant phase (HAP), portal venous phase (PVP) and delayed-phase (DP) helical CT images of 47 patients with 52 atypical small (or = 2 cm) HHs associated with 34 typical small HHs. Images were assessed to identify the patterns of enhancement of atypical HHs and correlate their appearance with that of typical small HHs in the delayed phase. Interobserver variability and kappa value were calculated. Statistical significance was calculated by the Fisher exact test.The 52 atypical small HHs were categorised as follows: type 1a (hyperattenuating in the HAP, n=17), type 1b [hyperattenuating with transient hepatic attenuation difference (THAD) around the lesion in the HAP, n=12], type 2a (homogeneously hypoattenuating in the HAP or PVP, n=9), type 2b (hypoattenuating with "bright-dot" sign in the HAP or PVP, n=13) and type 3 (hypoattenuating with central enhancing area, n=1). Interobserver agreement was perfect for HHs of types 1a, 1b, 2a and 3. On DP images, the appearance of atypical small HHs was identical to that of typical small HHs in all cases (p0.0001), with lesions showing homogeneous isoattenuation to the aorta or liver parenchyma without peripheral capsule.Triple-phase helical CT scans can distinguish several types of atypical small HHs. The demonstration of patterns similar to those of typical forms on DP CT is fundamental for the diagnosis.
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- 2009
157. Role of Plain Radiography in the Assessment of Ingested Foreign Bodies in the Pediatric Patients
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Roberta Grassi, Luca Brunese, Luigia Romano, Cecilia Lanza, Fabio Pinto, Andrea Giovagnoni, Antonio Pinto, Pinto, A, Lanza, C, Pinto, F, Grassi, Roberto, Romano, L, Brunese, L, and Giovagnoni, A. 2.
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Radiography, Abdominal ,Male ,medicine.medical_specialty ,Adolescent ,Radiography ,Thoracic ,Perforation (oil well) ,Wounds, Penetrating ,Sepsis ,Eating ,Penetrating ,Nuclear Medicine and Imaging ,medicine ,Ingestion ,Humans ,Radiology, Nuclear Medicine and imaging ,Abdominal ,Esophagus ,Child ,Preschool ,Gastrointestinal tract ,business.industry ,Child, Preschool ,Female ,Foreign Bodies ,Gastrointestinal Tract ,Infant ,Infant, Newborn ,Radiography, Thoracic ,Radiology, Nuclear Medicine and Imaging ,Medicine (all) ,Stomach ,digestive, oral, and skin physiology ,medicine.disease ,Newborn ,Surgery ,medicine.anatomical_structure ,Wounds ,Abdomen ,business ,Radiology - Abstract
Ingestion of various types of foreign bodies (FBs) such as coins, toy parts, jewelry pieces, needles and pins, fish and chicken bones, and button-type batteries is common among children. The curiosity of children and their need to investigate the world around them place them at a higher risk for ingestion of FBs. Fortunately, 80%-90% of ingested foreign objects that reach the stomach will pass uneventfully without intervention. The remainder may become blocked in the esophagus or other region of the alimentary tract, placing the pediatric patient at risk of significant complications such as aspiration, obstruction, bleeding, perforation, fistulization, sepsis, and death. The goals of the initial pediatric patient assessment are to identify the type of object ingested, its location in the gastrointestinal tract, and the presence of associated complications. Factors reported to increase the risk of complications included a sharp FB, a FB with a wide diameter, and symptoms. Plain radiographs still play an important role in the assessment of ingested FBs in the pediatric patient: plain films of the neck, chest, and abdomen are very useful in confirming the diagnosis of FB ingestion because most ingested FBs are radiopaque.
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- 2015
158. The Radiological Assessment of Axial Involvement in Psoriatic Arthritis
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Antonio Spadaro, Carlo Palazzi, Luca Brunese, Antonio Marchesoni, Salvatore D'Angelo, Ennio Lubrano, Nicola Ferrara, Philip S. Helliwell, Ignazio Olivieri, Raffaele Scarpa, Wendy J Parsons, Lubrano, E., Marchesoni, A., Olivieri, I., D'Angelo, S., Palazzi, C., Scarpa, R., Ferrara, Nicola, Parsons, W. J., Brunese, L., Helliwell, P. S., and Spadaro, A.
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medicine.medical_specialty ,Radiography ,Arthritis ,Sensitivity and Specificity ,Severity of Illness Index ,radiographic scoring methods ,Psoriatic arthritis ,Predictive Value of Tests ,Severity of illness ,medicine ,Humans ,Spondylitis, Ankylosing ,m-sasss ,Spondylitis ,psoriatic arthritis ,Ankylosing spondylitis ,basri ,business.industry ,Arthritis, Psoriatic ,PSORIATIC ARTHRITIS AXIAL INVOLVEMENT BASRI RADIOGRAPHIC SCORING METHODS m-SASSS PASRI ,General Medicine ,Prognosis ,medicine.disease ,Spine ,axial involvement ,pasri ,Predictive value of tests ,Radiological weapon ,Physical therapy ,Radiology ,business - Abstract
This article summarizes the state of radiological assessment of axial involvement in psoriatic arthritis (PsA). The definition and measurement of axial disease in PsA remain problematic and this situation in turn could affect the choice of approach to evaluate radiological findings of the spine. At present, the radiological assessment has been evaluated by using scoring systems borrowed from ankylosing spondylitis (AS). In particular, the Bath AS Radiology Index (BASRI) and the modified Stoke AS Spine Score (m-SASSS) have been validated for axial PsA. A recent study showed that BASRI and m-SASSS were valid instruments; however, neither score encompassed all radiological features of PsA. Therefore, a new index for assessing radiological axial involvement in PsA was developed - the PsA Spondylitis Radiology Index (PASRI). This new index encompassed a greater range of the spinal radiological features of PsA, providing a greater score range, and it correlated well with anthropometric and patient-reported outcomes. Recently, a study assessed the sensitivity to change of BASRI, m-SASSS, and PASRI, and showed that these 3 instruments provided a moderate sensitivity to change but high specificity to detect the true changes.
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- 2012
159. CT-guided biopsy of pulmonary nodules: is pulmonary hemorrhage a complication or an advantage?
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Rita Nizzoli, Ilaria Paladini, Antonio Rotondo, Raffaella Zagaria, Mario Silva, Marcello Tiseo, Cristina Rossi, Cecilia Bozzetti, Stefano Lipia, Massimo De Filippo, Luca Brunese, Luca Macarini, Andrea Ardizzoni, G Carrafiello, Luca Saba, Giorgio Concari, De Filippo, Massimo, Saba, Luca, Silva, Mario, Zagaria, Raffaella, Concari, Giorgio, Nizzoli, Rita, Bozzetti, Cecilia, Tiseo, Marcello, Ardizzoni, Andrea, Lipia, Stefano, Paladini, Ilaria, Macarini, Luca, Carrafello, Giampaolo, Brunese, Luca, Rotondo, Antonio, Rossi, Cristina, De Filippo, M, Saba, L, Silva, M, Zagaria, R, Concari, G, Nizzoli, R, Bozzetti, C, Tiseo, M, Ardizzoni, A, Lipia, S, Paladini, I, Macarini, L, Carrafiello, G, Brunese, L, and Rossi, C.
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Adult ,Image-Guided Biopsy ,Lung Diseases ,Male ,medicine.medical_specialty ,Radiology, Nuclear Medicine and Imaging ,Lung Neoplasms ,Radiography ,Biopsy, Fine-Needle ,Hemorrhage ,Radiography, Interventional ,Lung Disease ,Chest Imaging ,Risk Factors ,Biopsy ,medicine ,Humans ,Lung ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Incidence (epidemiology) ,Risk Factor ,Pneumothorax ,Middle Aged ,medicine.disease ,respiratory tract diseases ,Lung Neoplasm ,Fine-needle aspiration ,medicine.anatomical_structure ,Female ,Radiology ,Pulmonary hemorrhage ,business ,Complication ,Cardiology and Cardiovascular Medicine ,Tomography, X-Ray Computed ,Human - Abstract
PURPOSE: We aimed to assess the correlation between pulmonary hemorrhage and pneumothorax in computed tomography (CT)-guided transthoracic fine needle aspiration (TTFNA), particularly its possible value as protection against the development of pneumotorax. MATERIALS AND METHODS: We reviewed the CT images of 538 patients (364 males and 174 females, mean age 70 years, range 36-90 years) who underwent CT-guided TTFNA of pulmonary nodules between January 2008 and September 2013. The following CT findings were assessed: pulmonary hemorrhage (type 1, along the needle track; type 2, perilesional; low-grade, ≤6 mm; high-grade, >6 mm), pneumothorax, distance between the target nodule and the pleural surface, and emphysema. RESULTS: Pneumothorax occurred in 154 cases (28.6%) and pulmonary hemorrhage occurred in 144 cases (26.8%). The incidence of pneumothorax was lower in patients showing type 1 and high-grade pulmonary hemorrhage pattern. The incidence of pneumothorax in biopsies ≥30 mm from pleural surface was 26% (12/46) in cases showing this pattern, while it was 71.4% (30/42) when this pattern was not seen. Similarly, the incidence of pneumothorax in biopsies
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- 2014
160. Radiological and practical aspects of body packing
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Luca Brunese, Luigia Romano, Antonio Pinto, Fabio Pinto, Alfonso Reginelli, Fh Berger, Mariano Scaglione, Giacomo Sica, Pinto, A, Reginelli, Alfonso, Pinto, F., Sica, G., Scaglione, M., Berger, F. H., Romano, L., Brunese, L., Radiology and nuclear medicine, and Other Research
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Drug ,Adult ,Diagnostic Imaging ,Male ,medicine.medical_specialty ,Narcotic ,medicine.medical_treatment ,media_common.quotation_subject ,Body Packers ,Heroin ,Imaging modalities ,Bandage ,Cocaine ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Drug Trafficking ,Intensive care medicine ,Forensic radiology special feature: Review article ,media_common ,business.industry ,Impaction ,Illicit Drugs ,Medicine (all) ,Street Drug ,General Medicine ,Foreign Bodies ,Foreign Bodie ,Bandages ,Intestine ,Surgery ,Hospitalization ,Intestines ,Intestinal Perforation ,Radiological weapon ,Body Packing ,Vagina ,Female ,business ,Tomography, X-Ray Computed ,Intestinal Obstruction ,Human ,medicine.drug - Abstract
Body packing represents the concealment of illegal substances in a person's body with the aim of smuggling. “Body packers” either swallow drug-filled packets or introduce drug-filled packets into their bodies rectally or vaginally with the purpose of concealing them. The three main smuggled drugs are cocaine, heroin and cannabis products. Body packing represents a serious risk of acute narcotic toxicity from drug exposure, intestinal obstruction owing to pellet impaction and bowel perforation with consequent abdominal sepsis. A suspected body packer is generally admitted to hospital to perform imaging investigations and confirm the presence of drugs in his/her body. Radiological imaging methods are essential to diagnose body packing and to detect potential complications. Increasing sophistication of traffickers and improvements in packaging add to the detection difficulty. Radiologists should be aware of the appearance of drug packets in a range of imaging modalities. This article informs physicians about the challenging aspects of body packing, its background and medicolegal issues, what imaging methods can be used and what criteria are necessary to perform a correct diagnosis.
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- 2014
161. C-arm cone-beam computed tomography in interventional oncology: technical aspects and clinical applications
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Chiara, Floridi, Alessandro, Radaelli, Nadine, Abi-Jaoudeh, Michael, Grass, Micheal, Grass, MingDe, Lin, Ming, De Lin, Melanie, Chiaradia, Jean-Francois, Geschwind, Hicham, Kobeiter, Hishman, Kobeiter, Ettore, Squillaci, Geert, Maleux, Andrea, Giovagnoni, Luca, Brunese, Bradford, Wood, Gianpaolo, Carrafiello, Antonio, Rotondo, Floridi, C, Radaelli, A, Abi Jaoudeh, N, Grass, M, De Lin, M, Chiaradia, M, Geschwind, Jf, Kobeiter, H, Squillaci, E, Maleux, G, Giovagnoni, A, Brunese, L, Wood, B, Carrafiello, G, and Rotondo, Antonio
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Ablation Techniques ,Cone beam computed tomography ,medicine.medical_specialty ,Radiography ,ComputingMethodologies_IMAGEPROCESSINGANDCOMPUTERVISION ,Interventional oncology ,Ablation ,Radiography, Interventional ,Imaging guidance ,Percutaneous treatments ,Article ,Embolization ,Computer-Assisted ,Software ,Settore MED/36 - Diagnostica per Immagini e Radioterapia ,Neoplasms ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Cancer ,Neuroradiology ,Interventional ,medicine.diagnostic_test ,business.industry ,Cone-beam computed tomography ,Radiographic Image Interpretation ,Interventional radiology ,Equipment Design ,General Medicine ,Embolization, Therapeutic ,Cbct imaging ,Surgery, Computer-Assisted ,Cone-Beam Computed Tomography ,Radiographic Image Interpretation, Computer-Assisted ,Nuclear Medicine & Medical Imaging ,Imaging technology ,Biomedical Imaging ,Surgery ,Radiology ,Therapeutic ,business - Abstract
C-arm cone-beam computed tomography (CBCT) is a new imaging technology integrated in modern angiographic systems. Due to its ability to obtain cross-sectional imaging and the possibility to use dedicated planning and navigation software, it provides an informed platform for interventional oncology procedures. In this paper, we highlight the technical aspects and clinical applications of CBCT imaging and navigation in the most common loco-regional oncological treatments.
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- 2014
162. Long head of the biceps tendon and rotator interval
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Marcello Zappia, Anna Russo, F. Coppolino, Luca Brunese, G. F. D’Agosto, Eugenio Annibale Genovese, Alfonso Reginelli, F. Di Pietto, Zappia, M, Reginelli, Alfonso, Russo, A., D'Agosto, G. F., Di Pietto, F., Genovese, E. A., Coppolino, F., and Brunese, L.
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medicine.medical_specialty ,genetic structures ,Glenoid labrum ,Biceps pulley ,Long head biceps ,MRI arthrography ,Rotator interval lesion ,Humans ,Humerus ,Ligaments, Articular ,Rotator Cuff ,Rotator Cuff Injuries ,Scapula ,Shoulder Joint ,Tendon Injuries ,Magnetic Resonance Imaging ,Orthopedics and Sports Medicine ,Surgery ,Humeru ,Biceps ,Coracoid process ,Coracobrachialis muscle ,Tendon Injurie ,Bicipital groove ,medicine ,Rotator cuff ,Long head bicep ,Ligaments ,business.industry ,Supraglenoid tubercle ,Anatomy ,musculoskeletal system ,medicine.anatomical_structure ,Shoulder joint ,sense organs ,business ,Human ,Articular - Abstract
The term "biceps brachii" is a Latin phrase meaning "two-headed (muscle) of the arm." As its name suggests, this muscle has two separate origins. The short head of biceps is extraarticular in location, originates from the coracoid process of the scapula, having a common tendon with the coracobrachialis muscle. The long head of biceps tendon (LBT) has a much more complex course, having an intracapsular and an extracapsular portion. The LBT originates from the supraglenoid tubercle, and in part, from the glenoid labrum; the main labral attachments vary arising from the posterior, the anterior of both aspects of the superior labrum (Bletran et al. in Top Magn Reson Imaging 14:35-49, 2003; Vangsness et al. in J Bone Joint Surg Br 76:951-954, 1994). Before entering the bicipital groove (extracapsular portion), the LBT passes across the "rotator cuff interval" (intracapsular portion). Lesions of the pulley system, the LBT, and the supraspinatus tendon, as well as the subscapularis, are commonly associated (Valadie et al. in J Should Elbow Surg 9:36-46, 2000). The pulley lesion can be caused by trauma or degenerative changes (LeHuec et al. in J Should Elbow Surg 5:41-46, 1996). MR arthrography appears to be a promising imaging modality for evaluation of the biceps pulley, through the distention of the capsule of the rotator interval space and depiction of the associated ligaments.
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- 2013
163. Non-small cell lung cancer evaluated with quantitative contrast-enhanced CT and PET-CT: net enhancement and standardized uptake values are related to tumour size and histology
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Brunese, Luca, Greco, Barbara, Setola, Francesca Rosa, Lassandro, Francesco, Guarracino, Mario Rosario, De Rimini, Marialuisa, Piccolo, Sergio, De Rosa, Nicolina, Muto, Roberto, Bianco, Andrea, Muto, Pietro, Grassi, Roberto, Rotondo, Antonio, Brunese, L, Greco, B, Setola, Fr, Lassandro, F, Guarracino, Mr, De Rimini, M, Piccolo, S, De Rosa, N, Muto, R, Bianco, Andrea, Muto, P, Grassi, Roberto, and Rotondo, Antonio
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Male ,Lung Neoplasms ,genetic structures ,Contrast Media ,Positron emission tomography - computed tomography ,Adenocarcinoma ,Multimodal Imaging ,Tumor Burden ,Non-small cell lung carcinoma ,Multidetector computed tomography ,Fine needle aspiration biopsy ,Clinical Research ,Fluorodeoxyglucose F18 ,Carcinoma, Non-Small-Cell Lung ,Positron-Emission Tomography ,Humans ,Female ,Lung cancer ,Tomography, X-Ray Computed ,Aged - Abstract
Background Personalized cancer therapy remains a challenge. In this context, we attempted to identify correlations between tumour angiogenesis, tumour metabolism and tumour cell type. To this aim, we used single=phase multidetector computed tomography (MDCT) and hybrid positron emission tomography-computed tomography (PET/CT) to determine whether net enhancement and standardized uptake value (SUVmax) were correlated with tumour size and cytology in patients affected by non-small cell lung cancer (NSCLC). Material/Methods Our study included 38 patients (30 men, 8 women, mean age 70) with a NSCLC measuring between 3 cm and 7 cm, using a 16-slice multidetector CT (Brilliance Philips) and with PET-CT (Biograph 16 Siemens Medical Solutions). The following lesion parameters were evaluated: maximum diameter, medium density before contrast injection (CTpre), medium density after contrast injection (CTpost average), density in the most enhanced part of the lesion after contrast (CTpost max), net enhancement, SUVmax, age, and cytology. Correlation coefficient and p-value were computed for each pair of variables. In addition, correlations were computed for each pair of variables, and for all combinations of tumour types. We focused on subsets of data with more than 10 observations, and with correlation r>0.500 and p
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- 2013
164. B-flow twinkling sign in preoperative evaluation of cervical lymph nodes in patients with papillary thyroid carcinoma
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Andrea Bianco, Giuseppina Napolitano, Pio Zeppa, Maurizio Gasperi, Luca Brunese, Antonio Romeo, Napolitano, G, Romeo, A, Bianco, Andrea, Gasperi, M, Zeppa, P, and Brunese, L.
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Thyroid nodules ,Pathology ,medicine.medical_specialty ,Article Subject ,Endocrinology, Diabetes and Metabolism ,Hilum (biology) ,lcsh:Diseases of the endocrine glands. Clinical endocrinology ,B-flow sign ,Metastasis ,Papillary thyroid cancer ,Thyroid carcinoma ,lymph nodes ,papillary thyroid carcinoma ,Endocrinology ,Medicine ,Thyroid cancer ,lcsh:RC648-665 ,Endocrine and Autonomic Systems ,business.industry ,Echogenicity ,medicine.disease ,medicine.anatomical_structure ,Cervical lymph nodes ,Clinical Study ,Radiology ,business - Abstract
Papillary thyroid cancer (PTC) is the most common histologic type of differentiated thyroid cancer. The first site of metastasis is the cervical lymph nodes (LNs). The ultrasonography (US) is the best diagnostic method for the detection of cervical metastatic LNs. We use a new technique, B-flow imaging (BFI), recently used for evaluation of thyroid nodules, to estimate the presence of BFI twinkling signs (BFI-TS), within metastatic LNs in patients with PTC. Two hundred and fifty-two patients with known PTC were examined for preoperative evaluation with conventional US and BFI. Only 83 with at least one metastatic LN were included. All patients included underwent surgery; the final diagnosis was based on the results of histology. The following LN characteristics were evaluated: shape, abnormal echogenicity, absent hilum, calcifications, cystic appearance, peripheral vascularization, and BFI-TS. A total of 604 LNs were analyzed. Of these, 298 were metastatic, according to histopathology. The BFI-TS showed high valuesof specificity (99.7%) and sensitivity (80.9%). The combination of each conventional US sign with the BF-TS increases the specificity. Our findings suggest that BFI can be helpful in the selection of suspicious neck LNs that should be examined at cytologic examination for accurate preoperative staging and individual therapy selection.
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- 2013
165. Role of conventional radiology and MRi defecography of pelvic floor hernias
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Gianluca Gatta, Alfonso Reginelli, Melchiore Giganti, Graziella Di Grezia, F. Coppolino, Luca Brunese, Claudia Rossi, Francesca Iacobellis, Reginelli, Alfonso, Di Grezia, G, Gatta, Gianluca, Iacobellis, F, Rossi, C, Giganti, M, Coppolino, F, and Brunese, L.
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medicine.medical_specialty ,Hernia ,Pelvic Floor Disorders ,NO ,Enteroceles ,medicine ,Humans ,Defecography ,In patient ,MRi ,Hernias ,Pelvic floor ,medicine.diagnostic_test ,Conventional radiology ,business.industry ,Magnetic resonance imaging ,Pelvic Floor ,General Medicine ,medicine.disease ,Magnetic Resonance Imaging ,radiology ,digestive system diseases ,Elderly patients ,body regions ,stomatognathic diseases ,medicine.anatomical_structure ,surgical procedures, operative ,radiology, MRi,defecography ,MRI Defecography ,Female ,Surgery ,Radiology ,business ,Research Article - Abstract
Background Purpose of the study is to define the role of conventional radiology and MRI in the evaluation of pelvic floor hernias in female pelvic floor disorders. Methods A MEDLINE and PubMed search was performed for journals before March 2013 with MeSH major terms 'MR Defecography' and 'pelvic floor hernias'. Results The prevalence of pelvic floor hernias at conventional radiology was higher if compared with that at MRI. Concerning the hernia content, there were significantly more enteroceles and sigmoidoceles on conventional radiology than on MRI, whereas, in relation to the hernia development modalities, the prevalence of elytroceles, edroceles, and Douglas' hernias at conventional radiology was significantly higher than that at MRI. Conclusions MRI shows lower sensitivity than conventional radiology in the detection of pelvic floor hernias development. The less-invasive MRI may have a role in a better evaluation of the entire pelvic anatomy and pelvic organ interaction especially in patients with multicompartmental defects, planned for surgery.
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- 2013
166. MDCT in ischaemic colitis: how to define the aetiology and acute, subacute and chronic phase of damage in the emergency setting
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Luca Volterrani, Francesca Iacobellis, Roberto Grassi, Maria Antonietta Mazzei, Daniela Berritto, Luca Brunese, Giuseppe Guglielmi, Berritto, D, Iacobellis, F, Mazzei, M. A, Volterrani, L, Guglielmi, G, Brunese, L, and Grassi, Roberto
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Emergency Medical Services ,medicine.medical_specialty ,Colon ,Acute Disease ,Chronic Disease ,Colitis, Ischemic ,Humans ,Multidetector Computed Tomography ,Radiology, Nuclear Medicine and Imaging ,Lumen (anatomy) ,Colonoscopy ,Ischemic colitis ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Nuclear Medicine and Imaging ,Ischemic ,medicine ,Radiology, Nuclear Medicine and imaging ,Emergency Radiology Special Feature ,Colitis ,Pathological ,medicine.diagnostic_test ,business.industry ,General Medicine ,medicine.disease ,Vascular Disorder ,Etiology ,030211 gastroenterology & hepatology ,Histopathology ,Radiology ,business - Abstract
Ischemic colitis (IC) is the most common vascular disorder of the gastrointestinal tract with a reported incidence of 6.1-44 cases/100,000 person years with confirmatory histopathology. However, the true incidence of IC poses some difficulty, and even vigilant clinicians with patients at high risk often miss the diagnosis, since clinical presentation is non-specific or could have a mild transient nature. Detection of IC results is crucial to plan the correct therapeutic approach and reduce the reported mortality rate (4-12%). Diagnosis of IC is based on a combination of clinical suspicion, radiological, endoscopic and histological findings. Some consider colonoscopy as a diagnostic test of choice; however, preparation is required and it is not without risk, above all in patients who are severely ill. There are two manifestations of vascular colonic insult: ischaemic and reperfusive. The first one occurs above all during ischaemic/non-occlusive mesenteric ischaemia; in this case, the colonic wall appears thinned with dilated lumen and fluid appears in the paracolic space. When reperfusion occurs, the large bowel wall appears thickened and stratified, because of subepithelial oedema and/or haemorrhage, with consequent lumen calibre reduction. Shaggy contour of the involved intestine and misty mesentery are associated with the pericolic fluid. The pericolic fluid results are a crucial finding for IC diagnosis since its evidence suggests the presence of an ongoing damage thus focusing the attention on other pathological aspects which could be otherwise misdiagnosed, such as thinned or thickened colonic wall. Moreover, the pericolic fluid may increase or decrease, depending on the evolution of the ischaemic damage, suggesting the decision of medical or surgical treatment. Radiologists should not forget the hypothesis of IC, being aware that multidetector CT could be sufficient to suggest the diagnosis of IC, allowing for early identification and grading definition, and in a short-term follow-up, discriminating patients who need urgent surgery from patients in whom medical treatment and follow-up can be proposed.
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- 2016
167. Orbital fractures: role of imaging
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Paolo Fonio, Ferdinando Caranci, Salvatore Cappabianca, Luca Brunese, Francesco Briganti, Domenico Cicala, Caranci, F, Cicala, D, Cappabianca, Salvatore, Briganti, F, Brunese, L, Fonio, P., Caranci, Ferdinando, D., Cicala, S., Cappabianca, Briganti, Francesco, L., Brunese, and P., Fonio
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Diagnostic Imaging ,medicine.medical_specialty ,genetic structures ,Radiography ,Blunt ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Orbital Fracture ,Orbital Fractures ,Diplopia ,Surgical repair ,business.industry ,Enophthalmos ,Multiple Trauma ,medicine.disease ,eye diseases ,medicine.anatomical_structure ,Eye Foreign Bodies ,sense organs ,Radiology ,medicine.symptom ,business ,Orbit ,Penetrating trauma ,Orbit (anatomy) - Abstract
The orbit may be injured directly or indirectly. Blunt and penetrating trauma occurs with equal frequency. Soft tissue swelling often obscures direct clinical evaluation of the globe, limits ocular motion, and may limit clinical assessment of vision. Plain film radiographs of the orbits and sinuses are rarely used for diagnosis in orbital trauma. Computed tomography is considered the imaging modality of choice in this circumstance, as it is deemed to be the most accurate method in detecting fractures. The protocol is based on obtaining thin-section axial scans and multiplanar reformatted images, both are useful tools to guide treatment. Orbital fractures are not considered an ophthalmologic emergency unless there is visual impairment or globe injury. Surgical repair is indicated for patients who have persistent diplopia or cosmetic concerns (enophthalmos) and generaly is not performed until swelling subsides 7-10 days after injury.
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- 2012
168. Basilar artery hypoplasia
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M. Napoli, Mario Cirillo, Francesco Briganti, Ferdinando Caranci, Luca Brunese, G. Briganti, Caranci, F, Napoli, M., Cirillo, Mario, Briganti, G, Brunese, L, Briganti, F., Caranci, Ferdinando, M., Napoli, M., Cirillo, G., Briganti, L., Brunese, and Briganti, Francesco
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medicine.medical_specialty ,Aplasia ,Basilar artery ,Hypoplasia ,Magnetic resonance angiography ,Neurology (clinical) ,Radiology, Nuclear Medicine and Imaging ,Vertebrobasilar ischemia ,medicine.artery ,Nuclear Medicine and Imaging ,medicine ,Radiology, Nuclear Medicine and imaging ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,General Medicine ,equipment and supplies ,medicine.disease ,ARTERIAL ANOMALY ,Radiology ,Differential diagnosis ,business ,human activities - Abstract
A rare case of segmental hypoplasia of the basilar artery is described in a 49-year-old man with transient vertebrobasilar ischemia, explored by magnetic resonance imaging (MRI) and digital angiography (DA). The embryology, clinical relevance and magnetic resonance findings of this arterial anomaly are discussed, with a review of six previously reported cases. Segmental aplasia was suggested in our case by magnetic resonance, and subsequently confirmed not only by time-of-flight magnetic resonance, but also by DA. Only ultrathin-slice T2-weighted images revealed the real finding of basilar artery hypoplasia. This sequence, not employed in previously reported cases, is mandatory to allow a clear differential diagnosis between basilar artery aplasia and hypoplasia.
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- 2012
169. Strategies To Reduce Errors in Radiology
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Alfonso Reginelli, Ferdinando Caranci, Luca Brunese, Brunese, L., Reginelli, A., Caranci, F, L. ROMANO, A. PINTO, L., Brunese, A., Reginelli, and Caranci, Ferdinando
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medicine.medical_specialty ,Computer science ,Error analysis ,education ,medicine ,Image acquisition ,Headline ,Subject (documents) ,Radiology - Abstract
To err may indeed be human; nevertheless, society requires faultless medical professionals. For radiologists, being held to such standards is particularly challenging due to the rapidly advancing science of image acquisition. Errors in medicine have become headline news in recent years. Within radiology, the important progress in demonstrating disease has left error analysis a subject that is often mostly ignored.
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- 2012
170. Three-dimensional anal endosonography in depicting anal-canal anatomy
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Luca Brunese, Roberto Grassi, Y. Mandato, Carlo Cavaliere, Nunzia Luisa Pizza, Anna Russo, Alfonso Reginelli, Salvatore Cappabianca, Antonio Rotondo, Reginelli, Alfonso, Mandato, Y, Cavaliere, C, Pizza, Nl, Russo, A, Cappabianca, Salvatore, Brunese, L, Rotondo, Antonio, and Grassi, Roberto
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Adult ,Male ,Adolescent ,Anal Canal ,Statistics, Nonparametric ,Endosonography ,Imaging, Three-Dimensional ,Image Interpretation, Computer-Assisted ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Neuroradiology ,Aged ,Retrospective Studies ,medicine.diagnostic_test ,Normal anatomy ,business.industry ,Interventional radiology ,General Medicine ,Anatomy ,Anal canal ,Middle Aged ,medicine.anatomical_structure ,Female ,Anal sphincter ,business - Abstract
This report describes the advantages of 3D anal endosonography in depicting the normal anatomy of the anal canal in relation to sex and age.A retrospective study was performed of 85 patients, 33 men and 52 women, previously examined with 3D anal ultrasound (US) for clinically suspected anorectal disease but found to be negative. The examinations were performed with a Bruel and Kjaer US system with a 2050 transducer, scanning from the anorectal junction to the subcutaneous portion of the external anal sphincter (EAS). The 3D reconstructions provided an estimation of sphincter length in the anterior and posterior planes, and axial 2D images enabled calculation of the thickness of the internal anal sphincter (IAS) and EAS in the anterior, posterior and lateral transverse planes.Distribution of the sphincter complex is asymmetric in both sexes: the EAS and IAS are significantly shorter in females, especially in the anterior longitudinal plane (p=0.005 and p0.001, respectively). EAS and IAS thickness increases with age, especially the lateral IAS (R(2)=0.37, p0.001) and the posterior EAS (R(2)=0.29, p=0.01).A good knowledge of anal-canal anatomy is essential to detect sphincter abnormalities when assessing pelvic floor dysfunction.
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- 2012
171. Preliminary study on the correlation between grading and histology of solitary pulmonary nodules and contrast enhancement and [18F]fluorodeoxyglucose standardised uptake value after evaluation by dynamic multiphase CT and PET/CT
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Francesca Rosa Setola, Barbara Greco, Andrea Di Matteo, Francesca Antinolfi, Salvatore Cappabianca, Roberto Grassi, Mario Petrillo, Luca Brunese, Enrica Barra, Roberto Muto, Giuseppe Antinolfi, Annamaria Porto, Alfonso Reginelli, Francesco Michele Ronza, Giovanni Battista Rossi, Mara Catalano, Antonio Rotondo, Sergio Piccolo, Ilaria De Rosa, Pietro Muto, Mario Caputi, Nicoletta De Rosa, Maria Luisa De Rimini, Cappabianca, Salvatore, Porto, A, Petrillo, M, Greco, B, Reginelli, Alfonso, Ronza, F, Setola, F, Rossi, G, Di Matteo, A, Muto, R, De Rimini, Ml, Piccolo, S, Catalano, M, Muto, P, De Rosa, N, Barra, E, De Rosa, I, Antinolfi, F, Antinolfi, G, Caputi, M, Brunese, L, Grassi, Roberto, and Rotondo, Antonio
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Male ,medicine.medical_specialty ,Lung Neoplasms ,Adenocarcinoma ,Pathology and Forensic Medicine ,tumour angiogenesis ,Fluorodeoxyglucose F18 ,Hounsfield scale ,medicine ,diagnostics ,Humans ,Lung cancer ,Grading (tumors) ,Aged ,Retrospective Studies ,Fluorodeoxyglucose ,Aged, 80 and over ,Solitary pulmonary nodule ,PET-CT ,medicine.diagnostic_test ,Neovascularization, Pathologic ,business.industry ,Solitary Pulmonary Nodule ,General Medicine ,Middle Aged ,medicine.disease ,lung cancer ,Positron emission tomography ,Positron-Emission Tomography ,histopathology ,Female ,Original Article ,Radiology ,Angiogenesis ,Radiopharmaceuticals ,Nuclear medicine ,business ,Tomography, X-Ray Computed ,Perfusion ,medicine.drug - Abstract
Aim To evaluate whether the histology and grading of solitary pulmonary nodules (SPNs) correlated with the results of dynamic multiphase multidetector CT (MDCT) and the [ 18 F]fluorodeoxyglucose standardised uptake value (SUV) in 30 patients. Methods Chest x-rays of 270 patients with incidentally detected SPNs were retrospectively evaluated. Thirty patients with histologically proven SPNs were enrolled. On MDCT and positron emission tomography (PET)/CT images, two experts measured the density of nodules in all perfusion phases and the SUV. Net enhancement (NE) was calculated by subtracting peak pre-contrast density from peak post-contrast density. The Pearson test was used to correlate nodule NE, SUV, grading, histology and diameter. Results Of the 30 malignant SPNs, six were classified as G1 (median NE, 31.5 Hounsfield units (HU); median SUV, 4.8 units), 15 were classified as G2 (median NE, 49 HU; median SUV, 6 units), and nine were classified as G3 (median NE, 32 HU; median SUV, 4.5 units). A highly negative correlation was found in G3 SPNs between NE and the corresponding diameters (r=−0.834; p=0.00524). NE increased with the increase in diameter (r=0.982; p=0.284). SUV increased as the SPN diameter increased (r=0.789; p=0.421). NE and SUV were higher in G2 than G1 SPNs, and lower in G2 than G3 SPNs (r=0.97; p=0.137). Conclusions The significant correlation in dedifferentiated (G3) SPNs between NE and diameter (r=−0.834; p=0.00524) supports the theory that stroma and neoangiogenesis are fundamental in SPN growth. The highly negative correlation between NE and diameter demonstrates a net decrease in perfusion despite an increase in dimension. The multidisciplinary approach used herein may result in a more precise prognosis and consequently a better therapeutic outcome, particularly in patients with undifferentiated lung cancer.
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- 2011
172. Severe A(H1N1)-associated Pneumonia Sequential to Clamidophila pneumoniae Infection in Healthy Subject
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Bianco, A., Parrella, R., Esposito, V., Mazzarella, G., Sammarco, M. L., Luca Brunese, Ripabelli, G., Bianco, Andrea, Parrella, R, Esposito, V, Mazzarella, Gennaro, Sammarco, Ml, Brunese, L, and Ripabelli, G.
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Male ,Ofloxacin ,Coinfection ,Pneumonia, Viral ,Pneumonia ,Azithromycin ,Chlamydophila pneumoniae ,Middle Aged ,Antiviral Agents ,Anti-Bacterial Agents ,Cephalosporins ,Clamidophila pneumoniae ,Influenza A Virus, H1N1 Subtype ,Oseltamivir ,Influenza, Human ,Humans ,Drug Therapy, Combination ,Chlamydophila Infections ,A(H1N1) influenza ,Fluoroquinolones - Abstract
Background: Pandemic influenza virus has been implicated in serious lower airways illness and death in subjects both with and without underlying medical conditions . Predictive factors for severe disease in healthy individuals have not been identified. Case Report: Severe A(H1N1)-associated pneumonia occurring in a healthy subject without underlying medical conditions sequential to a Clamidophila pneumoniae infection, is reported. Conclusion: A potential synergistic mechanism by which other pathogens could interfere with the clinical course of A(H1N1) infection, is suggested.
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- 2011
173. I traumi del massiccio facciale
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Caranci, Ferdinando, Brunese, Luca, Resta, F., M. Resta, M. Resta, Caranci, Ferdinando, L., Brunese, F., Resta, Caranci, F., Brunese, L., and Resta, F.
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- 2011
174. Segmental hypoplasia of the basilar artery: a case report and review of literature
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Guerra, G., Caranci, Ferdinando, Tafuri, D., Soscia, A., Cinelli, M. P., Russo, A., Brunese, Luca, Montagnani, S., Guerra, G., Caranci, Ferdinando, Tafuri, D., Soscia, A., Cinelli, M. P., Russo, A., Brunese, L., Montagnani, S., G., Guerra, D., Tafuri, A., Soscia, M. P., Cinelli, A., Russo, Brunese, Luca, and S., Montagnani
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hypoplasia ,congenital, hereditary, and neonatal diseases and abnormalities ,aplasia ,magnetic resonance angiography ,basilar artery ,digital angiography ,basilar artery, aplasia, hypoplasia, magnetic resonance angiography, digital angiography - Abstract
The anomalies of the basilar artery are rare when compared with those ones pertaining to the circle of Willis vessels. Partial duplication or fenestration is rather common (0.6% to 1.8% in the angiographic descriptions); on the other hand, other anomalies, including complete duplication, hypoplasia and aplasia are exceptional. A rare case of segmental hypoplasia of the basilar artery in a 49-year-old man with transient vertebrobasilar (VB) ischemia, explored by magnetic resonance imaging (MRI) and digital angiography (DA), is reported. The embryology, the clinical relevance and the magnetic resonance findings of this arterial anomaly are discussed, with a review of other six reported cases. The appearance of a segmental aplasia was suggested in our case by MRI, and successively confirmed not only by time-of-flight MR-angiography (TOF-MRA) but also by DA. Only ultrathin-slice T2-weighted (w) images revealed the real finding of basilar artery (BA) hypoplasia; this sequence, not employed in previously reported cases, is mandatory to allowing a clear differential diagnosis between BA aplasia and hypoplasia. In conclusion, segmental hypo-aplasia of the BA is an exceptional embryological anomaly. This anomaly may be of clinical importance, and it should be considered among the potential causes of vertebrobasilar insufficiency in young adults. These cases should be investigated by MR and MRA; we stress the importance of ultrathin slice T2-weighted sequences in order to discriminate between aplasia and hypoplasia., Italian Journal of Anatomy and Embryology, Vol 116, No 1 (Supplement) 2011
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- 2011
175. Role of multidetector row computed tomography in the management of mandible traumatic lesions
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Mariano Scaglione, Salvatore Cappabianca, Luca Brunese, Antonio Pinto, Antonio Romeo, Romeo, A., Pinto, A., Cappabianca, Salvatore, Scaglione, M., and Brunese, L.
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medicine.medical_specialty ,Mandibular Injury ,Joint Dislocations ,Computed tomography ,Condyle ,Fractures, Bone ,stomatognathic system ,medicine ,Multidetector Row Computed Tomography ,Humans ,Radiology, Nuclear Medicine and imaging ,Joint dislocation ,Surgical treatment ,Facial Injuries ,medicine.diagnostic_test ,Management of Mandible Traumatic Lesions ,business.industry ,Mandibular Condyle ,Multislice computed tomography ,medicine.disease ,Mandibular Injuries ,Skull ,medicine.anatomical_structure ,Tomography x ray computed ,Radiology ,business ,Tomography, X-Ray Computed - Abstract
Facial injuries are common and must be radiologically evaluated to detect fractures, to determine their morphology and topography, and to assess adjacent soft-tissue damage. Spiral multislice computed tomography is progressively replacing conventional films for mandible traumatic lesions because it reveals the multiplicity of fragments, the degree of dislocation and rotation, and the extent of skull base involvement. Computed tomography is also very useful in the evaluation of condylar fractures, to determine the best choice for surgical treatment, open or close. 3-dimensional (3D) computed tomography images can display condylar fractures, but also all mandibular fractures, accurately and directly, and are very useful for surgeons to select treating methods of condylar fractures. The demonstration by imaging of the involvement of key anatomic structures is essential to classify correctly the trauma and to select the best management.
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- 2009
176. Multidetector row computed tomography with multiplanar and 3D images in the evaluation of posttreatment mandibular fractures
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Giuseppina Napolitano, Roberto Grassi, Luigi Califano, Luca Brunese, Sodano A, Napolitano, G, Sodano, A, Califano, L, Grassi, Roberto, Brunese, L., Califano, Luigi, and Grassi, R
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medicine.diagnostic_test ,Temporomandibular Joint ,business.industry ,Mandibular fracture ,Mandible ,Mandibular Condyle ,Computed tomography ,Diagnostic tools ,medicine.disease ,Condyle ,Temporomandibular joint ,Computed tomographic ,medicine.anatomical_structure ,Imaging, Three-Dimensional ,stomatognathic system ,Mandibular fossa ,Mandibular Fractures ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Postoperative Period ,Nuclear medicine ,business ,Tomography, X-Ray Computed ,Follow-Up Studies - Abstract
Multidetector row computed tomography with multiplanar (MPR) and 3-dimensional (3D) computed tomographic reconstructions is the method of choice in condylar fractures and in the presence of complications for all types of mandibular fracture. MPR and 3D images are the best diagnostic tools to evaluate mandibular fractures after surgical treatment, both after surgery and during follow-up. The conventional radiography is imprecise in the condylar region due to the complicated anatomical bone structures in the area, the lack of sharpness, and image distortion. Computed tomographic imaging enables the assessment of joint morphology and condyle position in the mandibular fossa 3-dimensionally in the absence of superimposed interfering structures. Moreover, it could evaluate functional of temporomandibular joint thought dynamic acquisition to close and open mouth.
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- 2009
177. Pulmonary congenital cystic disease in adults. Spiral computed tomography findings with pathologic correlation and management
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Irene Piscioli, Antonio Rotondo, S. Cappabianca, Francesco Barberini, S. Donato, Luca Brunese, Michele Scialpi, Luciano Lupattelli, Gb Scalera, Lucio Cagini, Scialpi, M, Cappabianca, Salvatore, Rotondo, Antonio, Scalera, Gb, Barberini, F, Cagini, L, Donato, S, Brunese, L, Piscioli, I, and Lupattelli, L.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Bronchogenic cyst ,Asymptomatic ,Bronchogenic Cyst ,Cystic Adenomatoid Malformation of Lung, Congenital ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Cyst ,Computed tomography ,Pathological ,Intrapulmonary bronchogenic cyst ,Intralobar sequestration ,Pulmonary congenital cystic disease ,Neuroradiology ,Aged ,Retrospective Studies ,spiral CT ,medicine.diagnostic_test ,business.industry ,Interventional radiology ,General Medicine ,Middle Aged ,medicine.disease ,Lobe ,Spiral computed tomography ,medicine.anatomical_structure ,Female ,Radiology ,medicine.symptom ,business ,Tomography, Spiral Computed - Abstract
The aim of this study was to assess the computed tomography (CT) features of intrapulmonary congenital cystic diseases in adults and to correlate the imaging features with the pathological findings, with emphasis on the oncogenic potential of the lesions. We retrospectively reviewed the CT scans in three institutions from August 1996 to December 2008, of nine patients (six men, three women; mean age 48.6 years; range 26–75 years) who had histological diagnosis of pulmonary cystic disease after surgery. Six patients had a diagnosis of intrapulmonary bronchogenic cyst (IBC), and three had a type-I cystic adenomatoid malformation (CAM). In one case, intralobar sequestration (ILS) was associated with type-I CAM. Three patients were symptomatic and six were asymptomatic. On CT scans, IBCs showed homogeneous fluid attenuation (n=2), air-fluid level (n=2), air attenuation (n=1) or soft-tissue attenuation (n=1). The surrounding lung tissue showed areas of band-like linear attenuation in three IBCs, atelectasia in two and mucocele-like areas in one. On CT, type-I CAM appeared as a unilocular cystic lesion with air-fluid level (n=1) or air content (n=1). Both cases had thin walls surrounded by normal lung parenchyma. ILS appeared as a fluid-filled cyst with afferent and efferent vessels. Of the six IBCs, one occurred in the upper right lobe, two in the middle lobe and three in the lower right lobe. Of the three type-I CAMs, one was in the upper left lobe and one in the middle lobe. The type-I CAM associated with ILS was located in the left lower lobe. The similar CT patterns preclude differentiation between IBC and type-I CAM. Surgical resection of all intrapulmonary cystic lesions detected in adults is mandatory because type-I CAM is a precursor of mucinous bronchioloalveolar carcinoma.
- Published
- 2009
178. Dynamic contrast-enhanced MR imaging for differentiation of renal cell carcinoma subtypes: myth or reality?
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Antonio Rotondo, Irene Piscioli, Michele Scialpi, Luca Brunese, Scialpi, M, Brunese, L, Piscioli, I, and Rotondo, Antonio
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medicine.medical_specialty ,Pathology ,business.industry ,MR ,carcinoma ,medicine.disease ,Mr imaging ,Dynamic contrast ,contrast-enhanced ,renal ,Renal cell carcinoma ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,business - Published
- 2009
179. Pleomorphic adenoma of parotid gland: delayed enhancement on computed tomography
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Salvatore Cappabianca, Giuseppina Napolitano, Sodano A, R. Ciccarelli, A Collina, V D'Auria, S Fucili, Luca Brunese, Anthony A. Romeo, Luigi Califano, Brunese, L, Ciccarelli, R, Fucili, S, Romeo, A, Napolitano, G, D'Auria, V, Collina, A, Califano, Luigi, Cappabianca, S, Sodano, A., Califano, L, and Cappabianca, Salvatore
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Adenoma ,Adenoma, Pleomorphic ,Contrast Media ,Pleomorphic adenoma ,Diagnosis, Differential ,Hounsfield scale ,medicine ,Carcinoma ,Image Processing, Computer-Assisted ,Humans ,Radiology, Nuclear Medicine and imaging ,Prospective Studies ,Prospective cohort study ,General Dentistry ,Aged ,Aged, 80 and over ,business.industry ,Carcinoma, Acinar Cell ,General Medicine ,Middle Aged ,medicine.disease ,Adenolymphoma ,Parotid gland ,Parotid Neoplasms ,Radiographic Image Enhancement ,Contrast medium ,medicine.anatomical_structure ,Otorhinolaryngology ,Carcinoma, Squamous Cell ,Carcinoma, Mucoepidermoid ,Female ,Radiology ,Differential diagnosis ,business ,Tomography, X-Ray Computed - Abstract
To assess the efficacy of multiphasic CT with 8 min delayed acquisition in the differential diagnosis between pleomorphic adenomas and other parotid neoplasias.Between January 2004 and April 2007, 62 patients with parotid enlargement were enrolled in this prospective study. The CT protocol applied included the following four acquisitions: without contrast medium and 30 s, 120 s and 8 min after intravenous injection of contrast medium. We considered the degree of the enhancement of the lesions (rated as "low", "moderate" and "strong") and the degree of enhancement homogeneity (rated as "not homogeneous", "mildly homogeneous" and "uniform"). These parameters were compared with Hounsfield values of the lesions computed in each phase. The diagnosis was confirmed in all patients after surgery.On histological examination, 36 tumours were classified as pleomorphic adenomas and 26 as non-pleomorphic adenomas. On the basis of a statistical comparison, the third phase proved to be the most effective in the differential diagnosis between pleomorphic adenoma and non-pleomorphic adenomas, both for the assessment of the degree of the enhancement (in this phase, strong enhancement showed a sensitivity of 61.11%, specificity of 100%, positive predictive value (PPV) of 100% and negative predictive value (NPV) of 53.33%) and, above all, for the homogeneity of the enhancement (in this phase, indeed, uniform enhancement showed sensitivity, specificity, PPV and NPV of 100%).Our results seem to indicate that multiphasic CT with 8 min delayed acquisition allows the differential diagnosis between pleomorphic adenomas and other parotid neoplasias.
- Published
- 2008
180. HRCT in detection of pulmonary infections from nontuberculous mycobacteria: personal experience
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Tullio Valente, E. Muto, Antonio Rotondo, Luca Brunese, I. Ferrara, Salvatore Cappabianca, R. Muto, Ferrara, I, Cappabianca, Salvatore, Brunese, L, Valente, T, Muto, E, Muto, R, and Rotondo, Antonio
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Adult ,Male ,medicine.medical_specialty ,Tuberculosis ,Mycobacterium Infections, Nontuberculous ,Computed tomography ,Pulmonary infection ,Medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Tuberculosis, Pulmonary ,Neuroradiology ,Aged ,Retrospective Studies ,Aged, 80 and over ,Bronchiectasis ,medicine.diagnostic_test ,biology ,business.industry ,General Medicine ,Mycobacterium Infections ,Middle Aged ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Nontuberculous mycobacteria ,Female ,Radiography, Thoracic ,Radiology ,business ,Tomography, X-Ray Computed - Abstract
The authors sought to assess the role of high-resolution computed tomography (HRCT) in the detection and follow-up of nontuberculous mycobacteria (NTM) pulmonary infection in immunocompetent patients and to identify the most common radiological patterns for diagnosis.Plain chest radiographs and HRCT scans of 42 consecutive patients with NTM pulmonary infection (M/F 26/16; mean age 57, range 41-83) were retrospectively reviewed. Ten of these patients were followed up for 18 months after diagnosis. Small nodules (10 mm), nodules 10- to 30-mm in diameter, lobar/segmental consolidation, cavitations, bronchiectasis and tree-in-bud pattern were analysed.Small nodules were more frequent than nodules 10- to 30-mm in diameter, and segmental consolidation was more frequent than lobar. Cavitations, tree-in-bud and bronchiectasis were more frequently located in the upper lobes. Four of the followed-up patients had cavitation of preexisting nodules, and five had progression of bronchiectasis.HRCT allows accurate detection and followup of the most frequent presentation patterns: diffuse small nodules, bronchiectasis, upper lobe segmental consolidation and cavitations. The appearance of new bronchiectasis and progression of old disease are due to pulmonary infection.
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- 2008
181. Lipomatous lesions of the head and neck region: imaging findings in comparison with histological type
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Salvatore Cappabianca, Luca Brunese, Francesco Iaselli, Martina Pezzullo, Anna Russo, Giuseppe Colella, Antonio Rotondo, Cappabianca, Salvatore, Colella, Giuseppe, Pezzullo, Mg, Russo, A, Iaselli, F, Brunese, L, and Rotondo, Antonio
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Adult ,Gadolinium DTPA ,Male ,Pathology ,medicine.medical_specialty ,Adolescent ,Contrast Media ,Fibroma ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Head and neck ,Child ,Neuroradiology ,Aged ,Aged, 80 and over ,medicine.diagnostic_test ,Histological type ,business.industry ,Ultrasound ,Magnetic resonance imaging ,Interventional radiology ,General Medicine ,Middle Aged ,equipment and supplies ,Magnetic Resonance Imaging ,Head and Neck Neoplasms ,Female ,Radiology ,Lipoma ,business ,Tomography, X-Ray Computed ,human activities - Abstract
Aim of the study is to demonstrate the main role of magnetic resonance imaging in the identification and characterization of lipomatous lesions of the head and neck.CT and MRI findings of 78 patients (43 male, 35 female) aged 12-80 (mean 47.5) years surgically treated for lipomatous lesions of the head and neck region between January 1995 and June 2005 were retrospectively analysed and correlated with the histological results.On CT images, lipomas and fibrolipomas appeared as smooth (38/50 cases) or lobulated (12/50 cases) well-defined masses associated with moderate displacement of surrounding tissues; tumours had high signal intensity on MR T1-weighted images, with relative decreasing signal on T2-weighted images. Infiltrating lipomas appeared as expansile ill-defined masses with heterogeneous signal. Angiolipomas showed a characteristic contrast enhancement on both CT and MRI. In one case of sialolipoma, the lesion appeared markedly heterogeneous in signal. MR and CT images of Madelung's disease showed multiple symmetrical lipomatous masses involving the neck region. Intraosseous fatty lesions appeared as well-defined hypodense masses sometimes associated with cortical expansion and disruption.Both CT and MRI exams are useful for detecting lipomatous lesions. MRI, however, is more accurate in the evaluation of their extent and in the characterisation of uncommon lipomatous lesions of the head and neck, and intravenous administration of gadolinium better depicts the margins of the tumour and its vascularisation.
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- 2008
182. Storia ed evoluzione della Radiologia odontostomatologica e maxillo-facciale
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CARDINALE, Adelfio, Rotondo A, Arcuri T, Becciolini A, Biti G, Blandino A, Brunese L, Canini R, Cappabianca S, Cardinale AE, Carriero A, Conti M, Cova M, De Maria M, Ettorre GC, Fanucci E, Gallucci M, Garlaschi G, Ghigi G, Giuseppetti GM, Grassi R, Guglielmi G, Iacomino A, Lupattelli L, Mansi L, Marini M, Maroldi R, Maurizi Enrici M, Morana G, Nessi R, Pirronti M, Rubini G, Sasso FS, Schillirò F, Scribano E, Sodano A, Tamburrini O, Terrosi Vagnoli P, Torricelli P., and CARDINALE ADELFIO
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Radiologia, odontostomatologia, maxillo-facciale, storia ,Settore MED/36 - Diagnostica Per Immagini E Radioterapia - Published
- 2008
183. Clinical utility of CT in children with persistent focal chest abnormality
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Silvia Montella, Luigi Greco, Luca Brunese, Mv Andreucci, Federico Barbarano, S. De Stefano, Francesca Santamaria, Montella, Silvia, Andreucci, Mv, Greco, Luigi, Barbarano, F, DE STEFANO, Sara, Brunese, L, and Santamaria, Francesca
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Adolescent ,Respiratory Tract Diseases ,Doppler echocardiography ,medicine ,Humans ,Child ,Prospective cohort study ,Sweat test ,Primary ciliary dyskinesia ,Bronchiectasis ,medicine.diagnostic_test ,business.industry ,Infant ,medicine.disease ,Surgery ,Chronic cough ,Cough ,Child, Preschool ,Atresia ,Female ,Radiography, Thoracic ,Radiology ,Abnormality ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
To the Editors: We read with interest the article by Li et al . 1 on the contribution of computed tomography (CT) in determining aetiological diagnosis of noncystic fibrosis (CF) bronchiectasis, and in leading to a change in management. We carried out a prospective study in 50 children (26 males; median age: 7.45 yrs, range: 12 months to 17 yrs) with chronic cough for >3 months and persistent focal chest abnormality on at least two conventional chest radiographs (CCR) made at intervals of ≥3 months. We aimed to assess what additional information CT (alone or combined with clinical findings and further diagnostic tests) provides, and to determine whether gaining such new information influences the clinical management. Sweat test, leukocytes blood count and purified protein derivative test for tuberculosis, electrocardiogram and Doppler echocardiography were normal or negative in all cases. Seven patients were affected by primary ciliary dyskinesia (PCD), five had previously undergone oesophageal atresia repair, three had common variable immunodeficiency and two were affected by Down's …
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- 2005
184. Detection of small (≤ 2 cm) pancreatic adenocarcinoma and surrounding parenchyma: correlations between enhancement patterns at triphasic MDCT and histologic features
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Irene Piscioli, Francesco De Santis, Alfredo D’Andrea, Michele Scialpi, Antonio Rotondo, Michelle Magli, Lucio Cagini, Luisa Pierotti, Teresa Pusiol, Luca Brunese, Scialpi, M, Cagini, L, Pierotti, L, De Santis, F, Pusiol, T, Piscioli, I, Magli, M, D'Andrea, A, Brunese, L, and Rotondo, Antonio
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Male ,Triphasic Helical CT ,medicine.medical_specialty ,Portal venous phase ,Sensitivity and Specificity ,Qualitative analysis ,Internal medicine ,Neoplasms ,Parenchyma ,Multidetector Computed Tomography ,medicine ,Carcinoma ,Humans ,Quantitative analysis ,Pancreas ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Helical Computed Tomography (CT), Neoplasms, Pancreas, Quantitative analysis, Triphasic Helical CT ,Gastroenterology ,General Medicine ,Hepatology ,Middle Aged ,medicine.disease ,Pancreatic Neoplasms ,Radiographic Image Enhancement ,medicine.anatomical_structure ,Helical Computed Tomography (CT) ,Pancreatitis ,Adenocarcinoma ,Female ,Radiology ,business ,Carcinoma, Pancreatic Ductal ,Research Article - Abstract
Background The aim is to assess the time-density curves (TDCs) and correlate the histologic results for small (≤ 2 cm) PDA and surrounding parenchyma at triphasic Multidetector-row CT (MDCT). Methods Triphasic MDCT scans of 38 consecutive patients who underwent surgery for a small PDA were retrospectively reviewed. The TDCs were analyzed and compared with histologic examination of the PDA and pancreas upstream/downstream in all cases. Three enhancement patterns were identified: 1) enhancement peak during pancreatic parenchymal phase (PPP) followed by a rapid decline on portal venous phase (PVP) and delayed phase (DP) at 5 minutes (type 1 pattern: normal pancreas); 2) maximum enhancement in PVP that gradually decreases in DP (type 2 pattern: mild chronic pancreatitis or PDA with mild fibrous stroma); 3) progressive enhancement with maximum peak in DP (type 3 pattern: severe chronic pancreatitis or PDA with severe fibrous stroma). A p value less than 0.05 was considered statistically significant. Sensitivity was calculated for PDA detection and an attenuation difference with the surrounding tissue of at least 10 HU was considered. Results PDA showed type 2 pattern in 5/38 cases (13.2%) and type 3 pattern in 33/38 cases (86,8%). Pancreas upstream to the tumor had type 2 pattern in 20/38 cases (52,6%) and type 3 pattern in 18/38 cases (47,4%). Pancreas downstream to the tumor had type 1 pattern in 19/25 cases (76%) and type 2 pattern in 6/25 cases (24%). Attenuation difference between tumor and parenchyma upstream was higher of 10 UH on PPP in 31/38 patients (sensitivity = 81.6%), on PVP in 29/38 (sensitivity = 76.3%) and on DP in 17/38 (sensitivity = 44.7%). Attenuation difference between tumor and parenchyma downstream was higher of 10 UH on PPP in 25/25 patients (sensitivity = 100%), on PVP in 22/25 (sensitivity = 88%) and on DP in 20/25 (sensitivity = 80%). Small PDAs were isodense to the pancreas upstream to the tumor, and therefore unrecognizable, in 8 cases (8/38; 21%) at qualitative analysis and in 4 cases (4/38; 10,5%) at quantitative analysis. Conclusions The quantitative analysis increases the sensitivity for detection of small PDA at triphasic MDCT.
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185. A Method for Real-Time Lung Nodule Instance Segmentation Using Deep Learning.
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Santone A, Mercaldo F, and Brunese L
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Lung screening is really crucial in the early detection and management of masses, with particular regard to cancer. Studies have shown that lung cancer screening, can reduce lung cancer mortality by 20-30% in high-risk populations. In recent times, the advent of deep learning, with particular regard to computer vision, demonstrated the ability to effectively detect and locate objects from video streams and also (medical) images. Considering these aspects, in this paper, we propose a method aimed to perform instance segmentation, i.e., by providing a mask for each lung mass instance detected, allowing for the identification of individual masses even if they overlap or are close to each other by classifying the detected masses into (generic) nodules, cancer or adenocarcinoma. In this paper, we considered the you-only-look-once model for lung nodule segmentation. An experimental analysis, performed on a set of real-world lung computed tomography images, demonstrated the effectiveness of the proposed method not only in the detection of lung masses but also in lung mass segmentation, thus providing a helpful way not only for radiologist to conduct automatic lung screening but also for discovering very small masses not easily recognizable to the naked eye and that may deserve attention. As a matter of fact, in the evaluation of a dataset composed of 3654 lung scans, the proposed method obtains an average precision of 0.757 and an average recall of 0.738 in the classification task. Additionally, it reaches an average mask precision of 0.75 and an average mask recall of 0.733. These results indicate that the proposed method is capable of not only classifying masses as nodules, cancer, and adenocarcinoma, but also effectively segmenting the areas, thereby performing instance segmentation.
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- 2024
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186. Radiomics and 256-slice-dual-energy CT in the automated diagnosis of mild acute pancreatitis: the innovation of formal methods and high-resolution CT.
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Rocca A, Brunese MC, Santone A, Varriano G, Viganò L, Caiazzo C, Vallone G, Brunese L, Romano L, and Di Serafino M
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Introduction: Acute pancreatitis (AP) is a common disease, and several scores aim to assess its prognosis. Our study aims to automatically recognize mild AP from computed tomography (CT) images in patients with acute abdominal pain but uncertain diagnosis from clinical and serological data through Radiomic model based on formal methods (FMs)., Methods: We retrospectively reviewed the CT scans acquired with Dual Source 256-slice CT scanner (Somatom Definition Flash; Siemens Healthineers, Erlangen, Germany) of 80 patients admitted to the radiology unit of Antonio Cardarelli hospital (Naples) with acute abdominal pain. Patients were divided into 2 groups: 40 underwent showed a healthy pancreatic gland, and 40 affected by four different grades (CTSI 0, 1, 2, 3) of mild pancreatitis at CT without clear clinical presentation or biochemical findings. Segmentation was manually performed. Radiologists identified 6 patients with a high expression of diseases (CTSI 3) to formulate a formal property (Rule) to detect AP in the testing set automatically. Once the rule was formulated, and Model Checker classified 70 patients into "healthy" or "unhealthy"., Results: The model achieved: accuracy 81%, precision 78% and recall 81%. Combining FMs results with radiologists agreement, and applying the mode in clinical practice, the global accuracy would have been 100%., Conclusions: Our model was reliable to automatically detect mild AP at primary diagnosis even in uncertain presentation and it will be tested prospectively in clinical practice., (© 2024. The Author(s).)
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- 2024
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187. An approach leveraging radiomics and model checking for the automatic early diagnosis of adhesive capsulitis.
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Varriano G, Nardone V, Brunese MC, Bruno M, Santone A, Brunese L, and Zappia M
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- Humans, Female, Male, Middle Aged, Shoulder Joint diagnostic imaging, Shoulder Joint pathology, Aged, Radiomics, Bursitis diagnostic imaging, Bursitis diagnosis, Magnetic Resonance Imaging methods, Early Diagnosis
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Adhesive Capsulitis of the shoulder is a painful pathology limiting shoulder movements, commonly known as "Frozen Shoulder". Since this pathology limits movement, it is important to make an early diagnosis. Diagnosing capsulitis relies on clinical assessment, although diagnostic imaging, such as Magnetic Resonance Imaging, can provide predictive or supportive information for specific characteristic signs. However, its diagnosis is not so simple nor so immediate, indeed it remains a difficult topic for many general radiologists and expert musculoskeletal radiologists. This study aims to investigate whether it is possible to use disease signs within a medical image to automatically diagnose Adhesive Capsulitis. To this purpose, we propose an automatic Model Checking-based approach to quickly diagnose the Adhesive Capsulitis taking as input the radiomic feature values from the medical images. Furthermore, we compare the performance achieved by our method with diagnostic results obtained by professional radiologists with different levels of experience. To the best of our knowledge, this is the first method for the automatic diagnosis of Adhesive Capsulitis of the Shoulder., (© 2024. The Author(s).)
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- 2024
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188. Prognostic Role of Lymphocyte-to-Monocyte Ratio (LMR) in Patients with Intermediate-Stage Hepatocellular Carcinoma (HCC) Undergoing Chemoembolizations (DEM-TACE or cTACE) of the Liver: Exploring the Link between Tumor Microenvironment and Interventional Radiology.
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Minici R, Venturini M, Guzzardi G, Fontana F, Coppola A, Piacentino F, Torre F, Spinetta M, Maglio P, Guerriero P, Ammendola M, Mgjr Research Team, Brunese L, and Laganà D
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Inflammation-based scores are biomarkers of the crosstalk between the tumor microenvironment and the immune response. Investigating the intricate relationship between the tumor stromal microenvironment, biomarkers, and the response to transcatheter arterial chemoembolization (TACE) is essential for early identification of TACE refractoriness or failure, providing insights into tumor biology and facilitating personalized therapeutic interventions. This study addresses a dearth of recent literature exploring the prognostic significance of the preoperative LMR in individuals from western countries diagnosed with stage B hepatocellular carcinoma (HCC) undergoing drug eluting microspheres TACE (DEM-TACE) or conventional TACE (cTACE). This international multi-center retrospective analysis included consecutive patients with stage B HCC who underwent TACE from January 2017 to June 2023. The study evaluated the ability of the preoperative LMR to predict complete response (CR), objective response (OR), sustained response duration (SRD) exceeding 6 months, successful downstaging at 6 months, progression-free survival (PFS) at 6 months, and overall survival (OS) at 6 months. The study population included 109 HCC patients and it was divided into low LMR (LMR < 2.24) and high LMR (LMR ≥ 2.24) groups, according to ROC curve analysis to select the optimal LMR cut-off value. High LMR was associated with lower Hepatitis C prevalence, higher absolute lymphocyte count, and a trend toward lower alpha-fetoprotein. The group with high LMRs exhibited superior CR rates (14.9% vs. 0%), overall OR (43.2% vs. 14.3%), and better PFS at 6 months (75.7% vs. 45.7%). The LMR, specifically categorized as <2.24 and ≥2.24, emerged as a robust predictor for treatment response and short-term outcomes in patients with stage B HCC undergoing DEM- or c-TACE.
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- 2024
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189. A Multicenter International Retrospective Investigation Assessing the Prognostic Role of Inflammation-Based Scores (Neutrophil-to-Lymphocyte, Lymphocyte-to-Monocyte, and Platelet-to-Lymphocyte Ratios) in Patients with Intermediate-Stage Hepatocellular Carcinoma (HCC) Undergoing Chemoembolizations of the Liver.
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Minici R, Venturini M, Guzzardi G, Fontana F, Coppola A, Piacentino F, Torre F, Spinetta M, Maglio P, Guerriero P, Ammendola M, Mgjr Research Team, Brunese L, and Laganà D
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Background: The utilization of inflammation-based scores, such as the Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR), and Platelet-to-Lymphocyte Ratio (PLR), has garnered attention for their potential as prognostic indicators in various cancers. However, their predictive role in patients with intermediate-stage HCC undergoing transcatheter arterial chemoembolization (TACE) remains an area that requires further investigation, as early recognition of TACE refractoriness holds the potential to guide tailored therapeutic interventions., Methods: This multicenter international retrospective study analyzed data from patients with intermediate-stage HCC undergoing TACE between 2018 and 2024. Inflammation-based scores (NLR, LMR, PLR) were assessed preoperatively to predict treatment outcomes., Results: Two hundred and fourteen patients were enrolled. Preoperative LMR showed the largest area under the curve for the prediction of 6-months PFS, based on the ROC curve analysis. Both high LMR (≥2.24) and low NLR (<4.72) were associated with improved objective response rates and 6-month progression-free survival. Lymphocyte count emerged as a strong predictor of treatment response in both simple ( p < 0.001) and multiple ( p < 0.001) logistic regression analyses., Conclusions: This study highlights the prognostic value of inflammation-based scores, particularly LMR and NLR, in predicting the treatment response and short-term outcomes of patients with intermediate-stage HCC undergoing TACE. Future investigations should focus on validating these scores' clinical applicability and assessing their impact on long-term patient survival and therapeutic decision-making.
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- 2024
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190. Quantitative ultrasound (QUS) in the evaluation of liver steatosis: data reliability in different respiratory phases and body positions.
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Rocca A, Komici K, Brunese MC, Pacella G, Avella P, Di Benedetto C, Caiazzo C, Zappia M, Brunese L, and Vallone G
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- Humans, Reproducibility of Results, Liver diagnostic imaging, Ultrasonography methods, Liver Cirrhosis pathology, Magnetic Resonance Imaging methods, Non-alcoholic Fatty Liver Disease diagnosis, Non-alcoholic Fatty Liver Disease pathology
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Liver steatosis is the most common chronic liver disease and affects 10-24% of the general population. As the grade of disease can range from fat infiltration to steatohepatitis and cirrhosis, an early diagnosis is needed to set the most appropriate therapy. Innovative noninvasive radiological techniques have been developed through MRI and US. MRI-PDFF is the reference standard, but it is not so widely diffused due to its cost. For this reason, ultrasound tools have been validated to study liver parenchyma. The qualitative assessment of the brightness of liver parenchyma has now been supported by quantitative values of attenuation and scattering to make the analysis objective and reproducible. We aim to demonstrate the reliability of quantitative ultrasound in assessing liver fat and to confirm the inter-operator reliability in different respiratory phases. We enrolled 45 patients examined during normal breathing at rest, peak inspiration, peak expiration, and semi-sitting position. The highest inter-operator agreement in both attenuation and scattering parameters was achieved at peak inspiration and peak expiration, followed by semi-sitting position. In conclusion, this technology also allows to monitor uncompliant patients, as it grants high reliability and reproducibility in different body position and respiratory phases., (© 2024. The Author(s).)
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- 2024
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191. Endovascular Treatment of Visceral Artery Pseudoaneurysms with Ethylene-Vinyl Alcohol (EVOH) Copolymer-Based Non-Adhesive Liquid Embolic Agents (NALEAs).
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Minici R, Guerriero P, Fontana F, Venturini M, Guzzardi G, Piacentino F, Coppola A, Spinetta M, Siciliano A, Serra R, Costa D, Ielapi N, Santoro R, On Behalf Of The Mgjr Research Team, Brunese L, and Laganà D
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Background and Objectives : Treatment of visceral artery pseudoaneurysms (VAPs) is always indicated regardless of their diameters, as their risk of rupture is significantly higher than that of visceral artery aneurysms. The invasiveness of surgery and its associated complications have led to a shift in favor of radiological interventions as the initial treatment of choice. However, there are still some unanswered questions on endovascular treatment of VAPs regarding the optimal endovascular technique and the efficacy and safety outcomes. The purpose of this multicenter study was to retrospectively evaluate the effectiveness and safety of endovascular treatment of visceral pseudoaneurysms using Ethylene-Vinyl Alcohol (EVOH) Copolymer-Based Non-Adhesive Liquid Embolic Agents (NALEAs). Materials and Methods : Consecutive patients who underwent endovascular embolization with EVOH-based NALEAs for visceral artery pseudoaneurysms between January 2018 and June 2023 were retrospectively evaluated. Results : 38 embolizations were performed. Technical success was achieved in all patients. The clinical success rate was high (92.1% overall), with no significant differences between ruptured and unruptured VAPs ( p = 0.679). Seven patients (18.4%) experienced procedure-related complications, related to one case of non-target embolization, four splenic abscesses due to end-organ infarction, and two femoral pseudoaneurysms. The rates of procedure-related complications, end-organ infarction, and vascular access-site complications did not significantly differ between ruptured and unruptured VAPs ( p > 0.05). Conclusions : Both ruptured and unruptured visceral pseudoaneurysms can be effectively and safely treated with NALEA-based endovascular embolization. We suggest considering the use of NALEAs, particularly in specific clinical cases that highlight their advantages, including patients with coagulopathy, fragile vessels, and embolization targets that are located at a considerable distance from the microcatheter tip and are otherwise difficult to reach.
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- 2023
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192. Explainable Convolutional Neural Networks for Brain Cancer Detection and Localisation.
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Mercaldo F, Brunese L, Martinelli F, Santone A, and Cesarelli M
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- Humans, Neural Networks, Computer, Records, Brain, Brain Neoplasms diagnostic imaging
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Brain cancer is widely recognised as one of the most aggressive types of tumors. In fact, approximately 70% of patients diagnosed with this malignant cancer do not survive. In this paper, we propose a method aimed to detect and localise brain cancer, starting from the analysis of magnetic resonance images. The proposed method exploits deep learning, in particular convolutional neural networks and class activation mapping, in order to provide explainability by highlighting the areas of the medical image related to brain cancer (from the model point of view). We evaluate the proposed method with 3000 magnetic resonances using a free available dataset. The results we obtained are encouraging. We reach an accuracy ranging from 97.83% to 99.67% in brain cancer detection by exploiting four different models: VGG16, ResNet50, Alex_Net, and MobileNet, thus showing the effectiveness of the proposed method.
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- 2023
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193. Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients.
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Minici R, Mercurio M, Guzzardi G, Venturini M, Fontana F, Brunese L, Guerriero P, Serra R, Piacentino F, Spinetta M, Zappia L, Costa D, Coppola A, Mgjr Research Team, Galasso O, and Laganà D
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- Humans, Retrospective Studies, Arteries diagnostic imaging, Pelvis, Embolization, Therapeutic, Vascular Diseases
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Background: Endovascular intervention is now the primary line of therapy for arterial injury brought on by pelvic trauma since it can significantly reduce considerable morbidity associated with surgery and can swiftly access and control bleeding sites. Despite international guidelines and widespread awareness of the role of angioembolization in clinical practice, robust evidence comparing the outcomes of angioembolization in hemodynamically stable and unstable patients is still lacking. This study aims to directly compare the outcomes of angioembolization for the treatment of pelvic traumatic arterial injury in patients with hemodynamic stability vs. hemodynamic instability., Methods: In our multicenter retrospective investigation, we analyzed data from consecutive patients who underwent, from January 2020 to May 2023, angioembolization for traumatic pelvic arterial injury., Results: In total, 116 angioembolizations were performed. Gelatin sponges (56.9%) and coils (25.9%) were the most widely used embolic agents. The technical and clinical success rates were 100% and 91.4%, respectively. No statistically significant differences were observed between the two groups in terms of technical success, clinical success, procedure-related complication rate, or 30-day bleeding-related mortality., Conclusions: Angioembolization is an effective and safe option for the management of traumatic pelvic arterial lesions even in hemodynamically unstable patients, despite technical variations such as greater use of prophylactic angioembolization.
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- 2023
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194. A Multicenter Retrospective Cohort Study Evaluating the Clinical Outcomes of Patients with Coagulopathy Undergoing Transcatheter Arterial Embolization (TAE) for Acute Non-Neurovascular Bleeding.
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Minici R, Fontana F, Venturini M, Guzzardi G, Piacentino F, Spinetta M, Bertucci B, Serra R, Costa D, Ielapi N, Coppola A, Guerriero P, Apollonio B, Santoro R, Mgjr Research Team, Brunese L, and Laganà D
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- Humans, Retrospective Studies, Treatment Outcome, Hemorrhage etiology, Hemorrhage therapy, Vascular Surgical Procedures, Embolization, Therapeutic, Blood Coagulation Disorders complications, Blood Coagulation Disorders therapy
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Background and Objectives : Transcatheter arterial embolization (TAE) is the mainstay of treatment for acute major hemorrhage, even in patients with coagulopathy and spontaneous bleeding. Coagulopathy is associated with worsening bleeding severity and higher mortality and clinical failure rates. Furthermore, some unanswered questions remain, such as the definition of coagulopathy, the indication for TAE or conservative treatment, and the choice of embolic agent. This study aims to assess the efficacy and safety of TAE for spontaneous non-neurovascular acute bleeding in patients with coagulopathy. Materials and Methods : This study is a multicenter analysis of retrospectively collected data of consecutive patients with coagulopathy who had undergone, from January 2018 to May 2023, transcatheter arterial embolization for the management of spontaneous hemorrhages. Results : During the study interval (January 2018-May 2023), 120 patients with coagulopathy underwent TAE for spontaneous non-neurovascular acute bleeding. The abdominal wall was the most common bleeding site (72.5%). The most commonly used embolic agent was polyvinyl alcohol (PVA) particles or microspheres (25.0%), whereas coils and gelatin sponge together accounted for 32.5% of the embolic agents used. Technical success was achieved in all cases, with a 92.5% clinical success rate related to 9 cases of rebleeding. Complications were recorded in 12 (10%) patients. Clinical success was significantly better in the group of patients who underwent correction of the coagulopathy within 24 h of TAE. Conclusions : Transcatheter arterial embolization (TAE) is effective and safe for the management of acute non-neurovascular bleeding in patients with coagulopathy. Correction of coagulopathy should not delay TAE and vice versa, as better clinical outcomes were noted in the subgroup of patients undergoing correction of coagulopathy within 24 h of TAE.
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- 2023
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195. Transcatheter Arterial Embolization (TAE) of Cancer-Related Bleeding.
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Minici R, Guzzardi G, Venturini M, Fontana F, Coppola A, Spinetta M, Piacentino F, Pingitore A, Serra R, Costa D, Ielapi N, Guerriero P, Apollonio B, Santoro R, Mgjr Research Team, Brunese L, and Laganà D
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- Humans, Gastrointestinal Hemorrhage etiology, Retrospective Studies, Treatment Outcome, Embolization, Therapeutic methods, Neoplasms complications, Neoplasms therapy
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Background and Objectives : Roughly 10% of cancer patients experience an episode of bleeding. The bleeding severity can range from occasional trivial bleeds to major bleeding. The treatment for the bleeding may vary, depending on the clinical condition and anatomical site, and may include various strategies, among which TAE is a cornerstone of major bleeding management. However, the existing literature on tumor hemorrhages is inconsistent. The objective of this multicenter retrospective cohort study was to evaluate the effectiveness and safety of arterial embolization in the treatment of tumor hemorrhages in patients with solid cancers. Materials and Methods : The data for patients with solid cancers undergoing TAE for the management of tumor hemorrhages from January 2020 to May 2023 were gathered. Results : A total of 92 patients with cancer-related bleeding were treated between January 2020 and May 2023. No bleeding was detected by X-ray angiography (XA) in 12 (13%) cases; therefore, a blind embolization was performed. The most common bleeding site was the liver (21.7%). A total of 66 tumor hemorrhages were spontaneous. The most commonly used embolic agent was polyvinyl alcohol (PVA) particles (30.4%). Technical success was achieved in 82 (89.1%) cases, with an 84.8% clinical success rate related to 14 cases of rebleeding. Proximal embolization was performed for 19 (20.7%) patients. Complications were recorded for 10 (10.9%) patients. The 30-day bleeding-related mortality was 15.2%. The technical success, clinical success, proximal embolization rate, and 30-day rebleeding were worse in the subset of patients undergoing TAE with coils. Conclusions : Transcatheter arterial embolization (TAE) represents a viable and potentially life-saving therapeutic approach in the management of tumor hemorrhages, demonstrating a notable effectiveness and safety. The TAE of bleeding tumors using coils resulted in a higher rate of non-superselective proximal embolization, with a trend toward lower clinical success rates and higher rebleeding episodes.
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- 2023
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196. Peritoneal Carcinosis: What the Radiologist Needs to Know.
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Reginelli A, Giacobbe G, Del Canto MT, Alessandrella M, Balestrucci G, Urraro F, Russo GM, Gallo L, Danti G, Frittoli B, Stoppino L, Schettini D, Iafrate F, Cappabianca S, Laghi A, Grassi R, Brunese L, Barile A, and Miele V
- Abstract
Peritoneal carcinosis is a condition characterized by the spread of cancer cells to the peritoneum, which is the thin membrane that lines the abdominal cavity. It is a serious condition that can result from many different types of cancer, including ovarian, colon, stomach, pancreatic, and appendix cancer. The diagnosis and quantification of lesions in peritoneal carcinosis are critical in the management of patients with the condition, and imaging plays a central role in this process. Radiologists play a vital role in the multidisciplinary management of patients with peritoneal carcinosis. They need to have a thorough understanding of the pathophysiology of the condition, the underlying neoplasms, and the typical imaging findings. In addition, they need to be aware of the differential diagnoses and the advantages and disadvantages of the various imaging methods available. Imaging plays a central role in the diagnosis and quantification of lesions, and radiologists play a critical role in this process. Ultrasound, computed tomography, magnetic resonance, and PET/CT scans are used to diagnose peritoneal carcinosis. Each imaging procedure has advantages and disadvantages, and particular imaging techniques are recommended based on patient conditions. Our aim is to provide knowledge to radiologists regarding appropriate techniques, imaging findings, differential diagnoses, and treatment options. With the advent of AI in oncology, the future of precision medicine appears promising, and the interconnection between structured reporting and AI is likely to improve diagnostic accuracy and treatment outcomes for patients with peritoneal carcinosis.
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- 2023
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197. The role of Lung Ultrasound in the diagnosis of SARS-COV-2 disease in pregnant women.
- Author
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Piccolo CL, Liuzzi G, Petrone A, Fusco N, Blandino A, Monopoli F, Antinori A, Girardi E, Vallone G, Brunese L, and Ianniello S
- Subjects
- Humans, Female, Pregnancy, SARS-CoV-2, Pregnant Women, Lung diagnostic imaging, Thorax, Ultrasonography methods, COVID-19 Testing, COVID-19 diagnostic imaging
- Abstract
Aim: To evaluate the role of lung ultrasound (LUS) in recognizing lung abnormalities in pregnant women affected by COVID-19 pneumonia., Materials and Methods: An observational study analyzing LUS patterns in 60 consecutively enrolled pregnant women affected by COVID-19 infection was performed. LUS was performed by using a standardized protocol by Soldati et al. The scoring system of LUS findings ranged from 0 to 3 in increasing alteration severity. The highest score obtained from each landmark was reported and the sum of the 12 zones examined was calculated., Results: Patients were divided into two groups: 26 (43.3%) patients with respiratory symptoms and 32 (53.3%) patients without respiratory symptoms; 2 patients were asymptomatic (3.3%). Among the patients with respiratory symptoms 3 (12.5%) had dyspnea that required a mild Oxygen therapy. A significant correlation was found between respiratory symptoms and LUS score (p < 0.001) and between gestational weeks and respiratory symptoms (p = 0.023). Regression analysis showed that age and respiratory symptoms were risk factors for highest LUS score (p < 0.005)., Discussion: LUS can affect the clinical decision course and can help in stratifying patients according to its findings. The lack of ionizing radiation and its repeatability makes it a reliable diagnostic tool in the management of pregnant women., (© 2022. Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB).)
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- 2023
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198. Transcatheter Arterial Embolization (TAE) in the Management of Bleeding in the COVID-19 Patient.
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Minici R, Fontana F, Venturini M, Guzzardi G, Siciliano A, Piacentino F, Serra R, Coppola A, Guerriero P, Apollonio B, Santoro R, Team MR, Brunese L, and Laganà D
- Subjects
- Humans, Retrospective Studies, Italy, Male, Female, Middle Aged, Aged, Aged, 80 and over, COVID-19 complications, Embolization, Therapeutic methods, Blood Coagulation Disorders therapy, Hemorrhage therapy
- Abstract
Background and Objectives : Increasing attention is being paid to the coagulation disorders associated with SARS-CoV-2 infection. Bleeding accounts for 3-6% of COVID-19 patient deaths, and is often a forgotten part of the disease. The bleeding risk is enhanced by several factors, including spontaneous heparin-induced thrombocytopenia, thrombocytopenia, the hyperfibrinolytic state, the consumption of coagulation factors, and thromboprophylaxis with anticoagulants. This study aims to assess the efficacy and safety of TAE in the management of bleeding in COVID-19 patients. Materials and Methods : This multicenter retrospective study analyzes data from COVID-19 patients subjected to transcatheter arterial embolization for the management of bleeding from February 2020 to January 2023. Results : Transcatheter arterial embolization was performed in 73 COVID-19 patients for acute non-neurovascular bleeding during the study interval (February 2020-January 2023). Coagulopathy was observed in forty-four (60.3%) patients. The primary cause of bleeding was spontaneous soft tissue hematoma (63%). A 100% technical success rate was recorded; six cases of rebleeding resulted in a 91.8% clinical success rate. No cases of non-target embolization were observed. Complications were recorded in 13 (17.8%) patients. The efficacy and safety endpoints did not differ significantly between the coagulopathy and non-coagulopathy groups. Conclusions : Transcatheter Arterial Embolization (TAE) is an effective, safe and potentially life-saving option for the management of acute non-neurovascular bleeding in COVID-19 patients. This approach is effective and safe even in the subgroup of COVID-19 patients with coagulopathy.
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- 2023
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199. Predicting risk of metastases and recurrence in soft-tissue sarcomas via Radiomics and Formal Methods.
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Casale R, Varriano G, Santone A, Messina C, Casale C, Gitto S, Sconfienza LM, Bali MA, and Brunese L
- Abstract
Objective: Soft-tissue sarcomas (STSs) of the extremities are a group of malignancies arising from the mesenchymal cells that may develop distant metastases or local recurrence. In this article, we propose a novel methodology aimed to predict metastases and recurrence risk in patients with these malignancies by evaluating magnetic resonance radiomic features that will be formally verified through formal logic models., Materials and Methods: This is a retrospective study based on a public dataset evaluating MRI scans T2-weighted fat-saturated or short tau inversion recovery and patients having "metastases/local recurrence" (group B) or "no metastases/no local recurrence" (group A) as clinical outcomes. Once radiomic features are extracted, they are included in formal models, on which is automatically verified the logic property written by a radiologist and his computer scientists coworkers., Results: Evaluating the Formal Methods efficacy in predicting distant metastases/local recurrence in STSs (group A vs group B), our methodology showed a sensitivity and specificity of 0.81 and 0.67, respectively; this suggests that radiomics and formal verification may be useful in predicting future metastases or local recurrence development in soft tissue sarcoma., Discussion: Authors discussed about the literature to consider Formal Methods as a valid alternative to other Artificial Intelligence techniques., Conclusions: An innovative and noninvasive rigourous methodology can be significant in predicting local recurrence and metastases development in STSs. Future works can be the assessment on multicentric studies to extract objective disease information, enriching the connection between the radiomic quantitative analysis and the radiological clinical evidences., Competing Interests: None declared., (© The Author(s) 2023. Published by Oxford University Press on behalf of the American Medical Informatics Association.)
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- 2023
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200. Radiomics and Artificial Intelligence Can Predict Malignancy of Solitary Pulmonary Nodules in the Elderly.
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Elia S, Pompeo E, Santone A, Rigoli R, Chiocchi M, Patirelis A, Mercaldo F, Mancuso L, and Brunese L
- Abstract
Solitary pulmonary nodules (SPNs) are a diagnostic and therapeutic challenge for thoracic surgeons. Although such lesions are usually benign, the risk of malignancy remains significant, particularly in elderly patients, who represent a large segment of the affected population. Surgical treatment in this subset, which usually presents several comorbidities, requires careful evaluation, especially when pre-operative biopsy is not feasible and comorbidities may jeopardize the outcome. Radiomics and artificial intelligence (AI) are progressively being applied in predicting malignancy in suspicious nodules and assisting the decision-making process. In this study, we analyzed features of the radiomic images of 71 patients with SPN aged more than 75 years (median 79, IQR 76-81) who had undergone upfront pulmonary resection based on CT and PET-CT findings. Three different machine learning algorithms were applied-functional tree, Rep Tree and J48. Histology was malignant in 64.8% of nodules and the best predictive value was achieved by the J48 model (AUC 0.9). The use of AI analysis of radiomic features may be applied to the decision-making process in elderly frail patients with suspicious SPNs to minimize the false positive rate and reduce the incidence of unnecessary surgery.
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- 2023
- Full Text
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