Dissection of cervicocephalic arteries: early diagnosis and follow-up with magnetic resonance imaging.

Evaluate Magnetic Resonance (MR) and Magnetic Resonance Angiography (MRA) sensibility in the diagnosis and follow-up of dissection of Internal Carotid and Vertebral Artery (ICA/VA). We revalued MR examination of 36 patients, 24 men, 12 women, aged 18-69 years. All patients underwent brain TC and MR (GE 1 Tesla); in 16 subjects 3D Time-of-Flight (TOF-3D) MRA was performed and in 20 subjects a Contrast-Enhanced MRA (CEMRA) of neck and head arteries. Thirty-one patients underwent a MRA follow-up. Dissection involved ICA in 30 and VA in 8. MR showed ischemic signs in 25 cases, wall hematoma in 19, and was normal in 11. MRA showed 25 vessels stenosis, 12 occlusions, and 9 aneurysm. Follow-up MRA showed 6 cases of complete resolution of stenosis, 17 partial resolution, 2 aneurysmal dissecanting, 6 luminal alteration unchanged, 1 aneurysma enlarged. MRA represented a non-invasive technique as investigation in suspected cervicocephalic arteries dissection.

Prevalence of Paget's disease of bone in Italy.

UNLABELLED: We examined the prevalence of PDB in Italy from radiological, scintigraphic, and biochemical surveys in two Italian towns. Prevalence rates varied from 0.7% to 2.4%, were higher in males than in females, and slightly differed between the two towns. Unlike previous studies in populations of British descent, no secular trend for a decreasing prevalence emerged. INTRODUCTION: Clinical, radiological, and necropsy data from different countries suggested pronounced geographical variations in the prevalence of Paget's disease of bone (PDB). Despite the impact of the disease on the population, there are limited data on the prevalence of PDB in Italy. MATERIALS AND METHODS: The objective of this study was to estimate the prevalence of PDB in the district of Siena (Central Italy) and Turin (Northern Italy) from radiological, biochemical, and scintigraphic surveys. We examined a sample of 1778 consecutive pelvic radiographs performed between 1999 and 2000 at the Hospital Radiology Unit in Siena and 6609 pelvic radiographs performed in 1986-1987, 1992-1993, and 1999-2002 from the Radiology Department of Molinette Hospital in Turin. In Siena, 7906 consecutive (99m)TC-MDP bone scans performed over a 4-year period (January 2000 to May 2004) were also screened for the presence of PDB, and the prevalence of elevated alkaline phosphatase (ALP) levels (>300 UI/liter) was estimated from 7449 computerized medical records over a 3-year period (January 2000 to February 2003). The finding of PDB on the pelvic radiograph and bone scan was based on standardized radiological criteria. RESULTS: At the end of the radiological surveys, 16/1778 pelvic PDB cases (8 males and 8 females) were observed in Siena and 41/6609 (27 males and 14 females) in Turin. The crude prevalence of the disease was 0.89% in Siena and 0.62% in Turin. Given that pelvic involvement is commonly described in 60-90% of PDB patients, the estimated overall prevalence of PDB ranged from 1.0% to 1.5% in Siena and from 0.7% to 1.0% in Turin. No decrease in the prevalence of PDB was evident after comparison of prevalence rates from different periods. Biochemical analyses showed 296/7449 subjects with elevated ALP levels and normal liver enzymes, 87 of whom had confirmed diagnosis of PDB. The estimated prevalence of biochemical PDB was 1.5%. The scintigraphic survey showed a PDB prevalence of 194/7906 (2.4%), which was significantly higher than the radiological and biochemical estimates. CONCLUSIONS: Our surveys suggest that PDB in Italy has an estimated prevalence of at least 1%, comparable with that observed in United States and other European countries, but lower than that described in Britain and New Zealand. No secular trend for a decreasing prevalence of PDB was observed.

[Magnetic resonance diagnosis of traumatic penile fracture].

PURPOSE: To report our experience with MRI in the preoperative evaluation of patients with traumatic penile fractures. MATERIALS AND METHODS: Between January 1998 and December 2001, we performed MRI examinations on five patients (aged 29-48 years; mean age 40 years) with suspected traumatic fracture of the penis occurred during sexual intercourse. In all cases, T1-weighted SE, T2-weighted FSE and GRE sequences in the axial, coronal and sagittal planes were acquired. The study was performed without IV administration of paramagnetic contrast agents and in conditions of detumescence. A small-sized surface coil was used in four cases and a body coil was used in one case. All patients had suspected penile fracture with indications for surgical repair. The MR examination was performed within 12 to 48 hours of the trauma and was requested to aid surgical planning. RESULTS: The MR image quality was adequate in all cases. The examination documented unilateral rupture of the corpus cavernosum in all patients. This finding was associated with haematoma located both subcutaneously and inside the corpus cavernosum itself. In no case was there rupture of both corpora cavernosa. In only one patient was there a suspicion of injuries to the urethral corpus spongiosum, which was confirmed by surgery along with the other MR findings. DISCUSSION AND CONCLUSIONS: Many imaging methods are available to evaluate traumatic penile lesions: ultrasound, colour-Doppler ultrasound, urethrography, cavernosography, angiography and MRI. In agreement with the literature, our experience shows that MRI is useful in evaluating penile injuries owing to its multiplanar capabilities, its good spatial resolution and its excellent tissue contrast resolution. These characteristics enabled a more adequate surgical approach. In our view, MRI can be regarded as an emerging method to obtain helpful diagnostic information, with no risks for the patient.