Use of DWI in identification of small solid pancreatic focalities (≤ 2 cm).

Incidental finding of pancreatic focalities has increased thanks to a larger use of radiological examinations (Ultrasound, CT). The differential diagnosis between focal inflammatory and heteroplastic disease is frequently complicated by the wide spectrum of lesions and by the aspecificity of clinical and medical history, as well as of imaging findings. MRI is the second level choice of examination thanks to its higher intrinsic contrast resolution and parametric capability (1); furthermore, the use of Diffusion Weighted Imaging (DWI) sequences provides additional diagnostic informations.

Defecography: a still needful exam for evaluation of pelvic floor diseases.

The aim of this discussion is to describe what is a defecography, how we have to perform it, what can we see and to present the main physio-pathological illnesses of pelvic floor and anorectal region that can be studied with this method and its advantages over other screening techniques. Defecography is a contrastographic radiological examination that highlights structural and functional pelvic floor diseases. Upon preliminary ileum-colic opacification giving to patient radiopaque contrast, are first acquired static images (at rest, in maximum voluntary contraction of the pelvic muscles, while straining) and secondarily dynamic sequences (during evacuation), allowing a complete evaluation of the functionality of the anorectal region and the pelvic floor. Defecography is an easy procedure to perform widely available, and economic, carried out in conditions where the patient experiences symptoms, the most realistic possible. It can be still considered reliable technology and first choice in many patients in whom the clinic alone is not sufficient and it is not possible or necessary to perform a study with MRI.

Imaging of congenital pulmonary malformations.

Congenital pulmonary malformations represent a broad spectrum of anomalies that may result in varied clinical and pathologic pictures, ranging from recurrent pulmonary infections and acute respiratory distress syndrome, which require timely drug therapy, up to large space-occupying lesions needing surgical treatment. This classification includes three distinct anatomical and pathological entities, represented by Congenital Cystic Adenomatoid Malformation, Bronchopulmonary Sequestration and Congenital Lobar Emphysema. The final result in terms of embryological and fetal development of these alterations is a Congenital Lung Hypoplasia. Since even Bronchial Atresia, Pulmonary Bronchogenic Cysts and Congenital Diaphragmatic Hernias are due to Pulmonary Hypoplasia, these diseases will be discussed in this review (1, 2).

CT arthrography for evaluation of autologous chondrocyte and chondral-inductor scaffold implantation in the osteochondral lesions of the talus.

PURPOSE: to analyse the findings of CT arthrography of the ankle, one year after the transplant of autologous chondrocytes in solution (ACI technique) and the covering with the only scaffold implantation of the osteochondral lesions of the talus, in comparison with the clinical evaluation of the ankle. METHODS: This retrospective study includes 10 patients (6 male, 4 female, mean age 49.4, range 25-74 years) with an osteochondral lesion of the medial side of the talus, 4 pure chondrals, 6 osteochondrals, painful and limiting the articulation, who underwent ACI using autologous chondrocyte (5 cases) and a covering with the only scaffold implantation (5 cases), in patients who underwent multi-detector CT arthrography between April 2006 and December 2013, at least 12 months after the surgery. RESULTS: Grade 0 was presented in 5 cases (50%), grade 1 in 2 cases (20%), grade 3 in 2 cases (20%) and grade 4 in 1 case (10%). Among the 5 cases even to 0 according to ICRS classification, the patient presented no symptoms in 4 out of 5 cases (80%); in 1 case, the patient presented post-operation pain of moderate entity due to the onset of adhesive capsulitis (20%). The 2 grade 1 patients, according to the ICRS classification, did not report any post-operation pain (0%). The 2 grade 3 patients, according to the ICRS classification, reported a light pain in 1 case (50%). The grade 4 patient, according to the ICRS classification, reported moderate pain (100%). CONCLUSIONS: The CT arthrography, for the elevate spatial and contrast resolution, is a very accurate exam in detecting irregularities in the chondral-inductor scaffold implantation, and in correlating the clinical presentation.

CT-guided fine-needle aspiration of abdominal and retroperitoneal small lesions with the coaxial technique using MPR images.

PURPOSE: To demonstrate the advantages of CT-guided fine-needle aspiration (FNA) of abdominal and retroperitoneal small lesions with the coaxial technique using MPR images. MATERIALS AND METHODS: The study included retrospectively 50 patients who underwent CT-guided FNA of abdominal and/or retroperitoneal small lesion (<30 mm). Patients with suspected lymphomas or sarcomas were excluded. Cytology reports were the reference standard. RESULTS: The cytology was diagnostic in 48/50 biopsies (96%): out of 41 neoplastic lesions (85%), 37 were malignant (90.2%) and 4 were benign (9.8%); 7 out of 48 were non-neoplastic (14.6%). No procedural complications were observed (0%). CONCLUSION: By using MPR images there is an effective improvement in coaxial CT-guided FNA of abdominal and retroperitoneal small lesions.

The use of magnetic resonance in myocardial ischaemia.

Despite the efforts that have been made at an international level to identify and control cardiovascular risk factors, cardiopathies and, in particular, coronary artery disease (CAD), remain the principal cause of death in Europe and the United States. These data confirm the importance and necessity of noninvasive, reliable diagnostic imaging of early CAD. Coronary angiography is still the hinge, around which all instrumental and laboratory investigations turn, for cardiac ischaemia today. Indeed, it still holds the role of "gold standard" for the study of the coronary arterial lumina, particularly the smaller vessels due to their complex spatial geometry and because of cardiac motion. At present, with the exception of the study of the coronary arterial lumen, MR is a non-invasive examination, already capable of supplying precise global and regional function, the evaluation of the intra-cardiac flow, myocardial perfusion and the overall viability of the heart.