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1.
AJNR Am J Neuroradiol ; 42(3): 546-550, 2021 03.
Article in English | MEDLINE | ID: mdl-33478941

ABSTRACT

BACKGROUND AND PURPOSE: The aspiration technique has gained a prominent role in mechanical thrombectomy. The thrombectomy goal is successful revascularization (modified TICI ≥ 2b) and first-pass effect. The purpose of this study was to evaluate the impact of the vessel-catheter ratio on the modified TICI ≥ 2b and first-pass effect. MATERIALS AND METHODS: This was a retrospective, single-center, cohort study. From January 2018 to April 2020, 111/206 (53.9%) were eligible after applying the exclusion criteria. Culprit vessel diameters were measured by 2 neuroradiologists, and the intraclass correlation coefficient was calculated. The receiver operating characteristic curve was used for assessing the vessel-catheter ratio cutoff for modified TICI ≥ 2b and the first-pass effect. Time to groin puncture and fibrinolysis were weighted using logistic regression. All possible intervals (interval size, 0.1; sliding interval, 0.01) of the vessel-catheter ratio were plotted, and the best and worst intervals were compared using the χ2 test. RESULTS: Modified TICI ≥ 2b outcome was achieved in 75/111 (67.5%), and first-pass effect was achieved in 53/75 (70.6%). The MCA diameter was 2.1 mm with an intraclass correlation coefficient of 0.92. The optimal vessel-catheter ratio cutoffs for modified TICI ≥ 2b were ≤1.51 (accuracy = 0.67; 95% CI, 0.58-0.76; P = 0.001), and for first-pass effect, they were significant (≤1.33; P = .31). The modified TICI ≥ 2b odds ratio and relative risk were 9.2 (95% CI, 2.4-36.2; P = 0.002) and 3.2 (95% CI, 1.2-8.7; P = .024). The odds ratio remained significant after logistic regression (7.4; 95% CI, 1.7-32.5; P = .008). First-pass effect odds ratio and relative risk were not significant (2.1 and 1.5; P > .05, respectively). The modified TICI ≥ 2b best and worst vessel-catheter ratio intervals were not significantly different (55.6% versus 85.7%, P = .12). The first-pass effect best vessel-catheter ratio interval was significantly higher compared with the worst one (78.6% versus 40.0%, P = .03). CONCLUSIONS: The aspiration catheter should be selected according to culprit vessel diameter. The optimal vessel-catheter ratio cutoffs were ≤1.51 for modified TICI ≥ 2b with an odds ratio of 9.2 and a relative risk of 3.2.


Subject(s)
Catheters , Stroke/surgery , Thrombectomy/instrumentation , Thrombectomy/methods , Aged , Cohort Studies , Female , Humans , Male , Middle Aged , Odds Ratio , Retrospective Studies , Treatment Outcome
2.
Radiol Med ; 116(1): 114-24, 2011 Feb.
Article in English, Italian | MEDLINE | ID: mdl-20927654

ABSTRACT

The aim of this paper is to review the role of computed tomography (CT) and magnetic resonance imaging (MRI) in managing chronic otitis media (COM), with special attention to the key information required by the otologist for effective preoperative planning.


Subject(s)
Magnetic Resonance Imaging , Otitis Media/pathology , Otitis Media/surgery , Tomography, X-Ray Computed , Chronic Disease , Humans , Preoperative Care
3.
J Laryngol Otol ; 124(8): 931-3, 2010 Aug.
Article in English | MEDLINE | ID: mdl-20082743

ABSTRACT

OBJECTIVES: We report a young man with bilateral enlarged internal auditory canals who developed sudden sensorineural hearing loss following weight-lifting exercise. METHODS: We present a detailed clinical history, including the patient's high resolution computed tomography and magnetic resonance imaging scans. RESULTS: The patient reported left-sided hearing loss immediately following weight-lifting exercise. He had no vestibular disturbance. He was treated with a combined regimen of steroids and an antiviral drug, but his profound hearing loss did not resolve. During another session of weight-lifting exercise, he suffered another episode of sudden hearing loss. CONCLUSIONS: To the best of our knowledge, this is the first report of a patient with patulous internal auditory canals, with no other anomalies, who developed bilateral sudden hearing loss after weight-lifting exercise. Although no definitive conclusions can be drawn, close surveillance and lifestyle warnings should be considered in such patients, even if they are clinically asymptomatic.


Subject(s)
Ear, Inner/abnormalities , Hearing Loss, Sudden/etiology , Weight Lifting , Adult , Audiometry, Pure-Tone , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Hearing Loss, Sudden/diagnosis , Humans , Magnetic Resonance Imaging , Male
4.
J Laryngol Otol ; 121(8): 736-41, 2007 Aug.
Article in English | MEDLINE | ID: mdl-17319988

ABSTRACT

AIM: To establish if the computed tomography (CT) and magnetic resonance imaging (MRI) appearances of the vestibule, after the removal of vestibular schwannoma by a modified translabyrinthine approach, correlate with a successful outcome, defined as hearing preservation. MATERIALS AND METHODS: Our study group consisted of 16 patients with vestibular schwannoma. All patients' pre-operative hearing was graded as class one or two according to the Gardner-Robertson scale. On MRI scans, the schwannoma, including the intracanalicular segment, were less than 2 cm in size in all the patients. The intracanalicular portion involved the fundus of the internal auditory canal in seven patients. In the remaining nine patients, the schwannoma had spread to involve two-thirds of the meatus, sparing its lateral third. The state of the labyrinth, in particular the integrity of the vestibule, was evaluated by CT scans and MRI prior to and following surgery. RESULTS: The schwannoma was completely removed in all patients. None showed any signs of persistence or tumoral relapse on the post-operative MRI. The final follow up showed that seven patients had maintained their hearing function (i.e. four patients with class one hearing and three with class two). The MRI vestibular signal on the T2-weighted images was well depicted only in patients with hearing preservation. Bony vestibular integrity was observed in the CT scans of all cases with hearing preservation, and also in three cases with failure of hearing preservation. CONCLUSION: Our results confirm that total isolation and maintenance of an anatomically intact vestibule, as depicted by MRI examination, is one of the fundamental factors for successful preservation of hearing function following modified translabyrinthine approach schwannoma removal.


Subject(s)
Hearing Loss/prevention & control , Neuroma, Acoustic/surgery , Otologic Surgical Procedures , Vestibule, Labyrinth/surgery , Adult , Aged , Female , Hearing , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Otologic Surgical Procedures/methods , Otologic Surgical Procedures/standards , Tomography, X-Ray Computed , Treatment Outcome
5.
Acta Otorhinolaryngol Ital ; 26(3): 147-53, 2006 Jun.
Article in English | MEDLINE | ID: mdl-17063984

ABSTRACT

Aim of the study was to evaluate the role of echo color/power Doppler and magnetic resonance imaging in the diagnosis of space occupying parotid lesions, in the attempt to establish criteria for differential diagnosis between benign and malignant types. The study population comprised 49 patients (23 male, 26 female), age range 30-85 years, with a space occupying lesion of the parotid gland. Each lesion was carefully studied with ultrasound integrated with colour/power doppler and magnetic resonance imaging; patients were then submitted to echo-guided needle-biopsy and surgical excision. A preliminary evaluation by means of ultrasound revealed the site, size of lesion, echostructure and borders. Echo colour/power Doppler and magnetic resonance imaging can play a very important role both in diagnosis and pre-operative surgical planning of parotid lesions, although cost and availability, the former to be recommended vs. magnetic resonance imaging, which is poorly accessible, expensive, and not always accepted by the patients.


Subject(s)
Magnetic Resonance Imaging , Parotid Neoplasms/diagnostic imaging , Parotid Neoplasms/pathology , Ultrasonography, Doppler, Color , Adult , Aged , Aged, 80 and over , Biopsy, Needle , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Neoplasm Staging , Ultrasonography, Doppler, Color/methods
6.
J Exp Clin Cancer Res ; 24(2): 209-15, 2005 Jun.
Article in English | MEDLINE | ID: mdl-16110753

ABSTRACT

The aim of the present study was to validate low dose Multislice Spiral Computed Tomography (MSCT) in the diagnosis of breast lesions. Fourteen patients with mammographic and ultrasound findings suspect of malignant neoplasm underwent dynamic MSCT of the breast under basal conditions and 1, 3, and 6 minutes after intravenous injection of iodinated contrast medium. Both enhancement of the lesion >100% without further increase after 6 minutes, and irregular margins of the lesion were considered signs of malignancy. All lesions were examined cytologically and/or histologically. A correct diagnosis was achieved by MSCT in 7/8 malignant lesions, and in 6/6 benign lesions. The only malignant lesion missed by MSCT was histologically a ductal carcinoma in situ (false negative). In one case the MSCT showed the multifocality of an infiltrating ductal carcinoma, and in another it defined the bilaterality of the malignant lesions. Sensitivity and specificity of MSCT in the diagnosis of malignancy of a lesion were 88% and 100%, respectively. Our results suggest that MSCT is an effective diagnostic method to define suspicious breast lesions, and a valid alternative to Magnetic Resonance Imaging, especially when the latter is not feasible.


Subject(s)
Breast Neoplasms/diagnosis , Carcinoma, Ductal, Breast/diagnosis , Mammography/methods , Tomography, Spiral Computed/methods , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/pathology , Carcinoma, Ductal, Breast/diagnostic imaging , Carcinoma, Ductal, Breast/pathology , Contrast Media/administration & dosage , Female , Humans , Iodine Radioisotopes/administration & dosage , Sensitivity and Specificity , Time Factors
7.
Minerva Stomatol ; 54(4): 219-26, 2005 Apr.
Article in English, Italian | MEDLINE | ID: mdl-15973235

ABSTRACT

AIM: The aim of the study is to evaluate the quality of the temporal mandibular joint (TMJ) imaging in patients with lack of condyle-disk coordination with the Half-Fourier Acquisition Single Shot Turbo Spin Echo (HASTE), and compare it with the quality of TSE T2-weighted images. METHODS: Twenty-seven patients were selected (12 men and 15 women; age range 17-69 years) with medical history negative for facial trauma or surgery. The instrument used was a Siemens 1.5 Tesla with bilateral coil dedicated for studying both TMJs. TSE T2-weighted and HASTE images in the parasagittal axis with open and closed mouth were obtained for both joints. RESULTS: The quality of the TSE T2-weighted images was better for all parameters considered (both at open and at closed mouth) than the HASTE images; however, the latter method is considerably quicker. CONCLUSIONS: HASTE was found to be a valid method for use as rapid screening to study the TMJ and for use in patients who are unable to maintain an immobile position. Time and cost required for the examination are drastically reduced.


Subject(s)
Magnetic Resonance Imaging/methods , Temporomandibular Joint Disorders/diagnosis , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged
8.
G Chir ; 26(1-2): 37-9, 2005.
Article in Italian | MEDLINE | ID: mdl-15847093

ABSTRACT

Primary sclerosing cholangitis (PSC) is an idiopathic chronic inflammatory condition affecting intra- and extra-hepatic biliary system. The aim of this study is to stress the importance of cholecystectomy in patients with PSC. Consideration should be given to performing a cholecystectomy in PSC patients with gallbladder adenomyomas or calculi, even asymptomatic; this happens in approximately 15% of cases.


Subject(s)
Cholangitis, Sclerosing/surgery , Cholecystectomy , Adenoma/complications , Adenoma/pathology , Bile Ducts/pathology , Cholangitis, Sclerosing/complications , Cholangitis, Sclerosing/diagnosis , Cholangitis, Sclerosing/pathology , Cholecystitis/complications , Cholecystolithiasis/complications , Cholecystolithiasis/pathology , Chronic Disease , Follow-Up Studies , Gallbladder/pathology , Gallbladder Neoplasms/complications , Gallbladder Neoplasms/pathology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Time Factors
9.
G Chir ; 25(1-2): 43-6, 2004.
Article in Italian | MEDLINE | ID: mdl-15112761
11.
J Exp Clin Cancer Res ; 23(4): 585-92, 2004 Dec.
Article in English | MEDLINE | ID: mdl-15743028

ABSTRACT

The purpose of this research was to evaluate the role of Echo Colour/Power Doppler and Magnetic Resonance Imaging (MRI) in the diagnosis of expansive parotid lesions, and to establish criteria for differential diagnosis between benign and malignant forms. Forty nine patients (23 males and 26 females), aging from 30 to 85 years, with an expansive pathology of parotid gland were enrolled in our study from February 1999 through August 2004. Each patient was carefully assessed employing both ultrasonography integrated with Color/Power Doppler and MRI. Eventually, all patients received echo-guided needle-biopsy and surgical excision of the parotid lesion. Preliminary ultrasound assessed site, size, echoic appearance and margins of the lesion. In order to assess blood supply by means of Colour/Power Doppler, we divided the patients in four groups. Our MRI diagnostic criteria included site, size, intensity of signal, behaviour of the lesion after i.v. contrast, relationship with facial nerve and retromandibular vein, detection of margins and proximity to adjacent structures. On the basis of our results, the Authors concluded that both Echo Colour/Power Doppler and MRI play a very important role in the diagnosis and surgical planning of parotid gland lesions.


Subject(s)
Carcinoma/pathology , Echo-Planar Imaging/methods , Parotid Neoplasms/diagnosis , Parotid Neoplasms/pathology , Adenoma , Adult , Aged , Aged, 80 and over , Carcinoma/diagnosis , Carcinoma/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging/methods , Male , Middle Aged , Parotid Gland/pathology , Parotid Neoplasms/diagnostic imaging , Radiography , Time Factors
12.
Clin Ter ; 154(4): 245-50, 2003.
Article in Italian | MEDLINE | ID: mdl-14618941

ABSTRACT

MRI is a multiparametric, multiplanar, non-invasive largely employed tool for assessing osseous, ligamentous and tendineous injuries, inflammatory and degenerative changes of the knee. Although its wider availability and the lack of ionizing radiations MRI should be used only if clinically useful in patient management, in a appropriate diagnostic iter including plain film and/or ultrasound examination. The aim of our work is to review possibilities, limits and current indications for MRI assessment of diseases of the knee.


Subject(s)
Knee/pathology , Magnetic Resonance Imaging , Humans , Joint Capsule/pathology , Joint Diseases/pathology , Knee Injuries/pathology
14.
J Exp Clin Cancer Res ; 22(1): 35-9, 2003 Mar.
Article in English | MEDLINE | ID: mdl-12725320

ABSTRACT

The aim of the present study was to assess the role of virtual cystoscopy in the identification of bladder tumors. Fifteen patients (11 men and 4 women, median age: 61 years, range: 46-74 years) with a positive finding of bladder tumor at fiber-optic cystoscopy were studied by multislice-CT. Scans were downloaded to a workstation with the aid of a software for the processing of 3-D reconstructions, with a volume-rendering technique which allowed the "navigation" within the bladder in search of wall lesions. In this group of 15 patients, cystoscopy was able to detect 19 neoplastic lesions, 13 with a diameter >10 mm and 6 with a diameter <10 mm. Virtual cystoscopy, instead, identified 17 lesions (89%) only. In particular, all those lesions with a diameter >1 cm (13/13=100%) were correctly identified, whereas only 4 of the 6 lesions with a diameter <1 cm were depicted. The 2 false negative cases were 2 lesions with a flat morphology, measuring 5 and 6 mm. Most recent technological advances allowed the employement of virtual endoscopies, characterized by the absence of invasivity as compared with fiber-optic studies and based on data obtained by spiral- and multislice-CTs. According to our experience, virtual CT-cystoscopy revealed to be a complementary tool in the evaluation of cross-sectional images and proved to be an easy procedure without complications, well-accepted by the patients, and with a reliable detection of those bladder lesions measuring more than 5 mm in case of polypoid formations and at least 10 mm in case of flat lesions. This technique, however, does not allow the collection of a bioptic sample and--with the present resolution power of available equipments--it could be unable to correctly detect small-sized flat lesions. We, nonetheless, believe that this procedure, in the future, thanks to rapid technological improvements in virtual imaging techniques, could become a useful diagnostic tool in the management of those patients with bladder tumors. Further studies on larger study groups are therefore desirable for a more reliable validation of the technique.


Subject(s)
Tomography, X-Ray Computed/methods , Urinary Bladder Neoplasms/diagnostic imaging , Aged , Cystoscopy/methods , Female , Fiber Optic Technology , Humans , Image Processing, Computer-Assisted , Male , Middle Aged , Optical Fibers , Reproducibility of Results , Sensitivity and Specificity , Urinary Bladder Neoplasms/pathology
15.
G Chir ; 24(10): 347-9, 2003 Oct.
Article in English | MEDLINE | ID: mdl-14722994

ABSTRACT

Cystic lymphangioma is a benign tumor of uncertain etiology characterized by a slow growth; in 2-8% of cases it is localized in the mesentery. Symptomatology is aspecific and preoperative diagnosis is often difficult. The Authors report the case of a mesenteric cystic lymphangioma in a patient who had undergone subtotal colectomy eight years earlier for an adenocarcinoma occluding the sigmoid colon. The patient was hospitalized for intestinal occlusion.


Subject(s)
Intestinal Obstruction/etiology , Lymphangioma/complications , Mesentery , Peritoneal Neoplasms/complications , Humans , Lymphangioma/pathology , Male , Mesenteric Cyst/complications , Mesenteric Cyst/pathology , Middle Aged , Peritoneal Neoplasms/pathology
16.
Radiol Med ; 104(3): 165-84, 2002 Sep.
Article in English, Italian | MEDLINE | ID: mdl-12471365

ABSTRACT

Since the introduction of the "Dentascan" reconstruction program, the use of CT in the field of odontostomatology has attracted growing interest from both radiologists and dentists. Over the years, the potential applications of Dentascan have extended from the management of implantology-related issues to the study of all jaw bone diseases relevant to dentists. This paper describes the technical aspects and current diagnostic capabilities of computed tomography of the dental arches with dedicated software, by presenting a wide selection of case studies.


Subject(s)
Dental Arch/diagnostic imaging , Jaw Diseases/diagnostic imaging , Radiography, Dental/methods , Software Validation , Tomography, X-Ray Computed , Dental Implants , Diagnosis, Differential , Humans , Image Processing, Computer-Assisted , Radiography, Panoramic
18.
Radiol Med ; 104(1-2): 58-67, 2002.
Article in English, Italian | MEDLINE | ID: mdl-12386556

ABSTRACT

PURPOSE: To assess the value of MRI performed with phased-array coil in the diagnosis and preoperative staging of perianal and anal fistulas. MATERIALS AND METHODS: 20 patients (13 with Crohn's disease) with clinical evidence or suspicion of anal fistulas underwent pelvic MRI (1.5 T) performed with phased-array coil. Images were obtained in the axial and coronal planes using TSE T2-weighted high resolution sequences with and without fat suppression, T2-weighted HASTE and T1-weighted FLASH sequences, with and without fat suppression, before and after gadolinium enhancement. The following parameters were considered: presence of a fistula and relation with the sphincters, and presence of abscesses or complications. All patients underwent surgery. The MRI and surgical findings were assessed using the Park's fistula-in-ano classification and the St. James MR imaging classification of perianal fistulas. Surgery was considered the gold standard. RESULTS: MRI documented no evidence of fistula in 2 patients, intersphinteric fistulas in 5 (grade 1 and 2 St. James), trans-sphincteric fistulas in 9 (grade 3 and 4 St. James), translevator in 2 (grade 5) and complex ano-rectum-vaginal fistulas in 2. Concordance with surgery was 90%. CONCLUSIONS: MRI is an accurate technique for the identification and classification of anal and perianal fistulas and their complications. In our experience the phased-array coil offers both high field of view and spatial resolution, enabling the demonstration of perianal pathology.


Subject(s)
Magnetic Resonance Imaging , Rectal Fistula/diagnosis , Adolescent , Adult , Aged , Crohn Disease/complications , Crohn Disease/surgery , Female , Humans , Magnetic Resonance Imaging/instrumentation , Magnetic Resonance Imaging/methods , Male , Middle Aged , Proctoscopy , Rectal Fistula/classification , Rectal Fistula/etiology , Rectal Fistula/surgery , Sensitivity and Specificity , Time Factors
19.
J Exp Clin Cancer Res ; 21(4): 613-6, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12636110

ABSTRACT

Horseshoe kidney is a congenital anomaly of the upper urinary system frequently associated with atypical vascularization, mostly asymptomatic, usually undetected until the onset of infectious, obstructive or neoplastic complications. Although intravenous pyelography and US are useful tools, the role of CT is of vital importance especially in the pre-operative planning of related complications and in those cases where other techniques have correctly diagnosed the disease but have missed the visualization of an underlying malformation. We report here two cases of adenocarcinoma in two patients with a horseshoe kidney, where CT has clearly depicted both the malformation and the associated pathologic findings.


Subject(s)
Adenocarcinoma/diagnostic imaging , Kidney Neoplasms/diagnostic imaging , Kidney/abnormalities , Adenocarcinoma/surgery , Cell Transformation, Neoplastic , Diagnosis, Differential , Humans , Kidney/diagnostic imaging , Kidney/pathology , Kidney Neoplasms/surgery , Male , Middle Aged , Reproducibility of Results , Tomography, X-Ray Computed , Treatment Outcome
20.
Clin Ter ; 153(5): 347-9, 2002.
Article in Italian | MEDLINE | ID: mdl-12510421

ABSTRACT

Esthesioneuroblastoma, also known as olfactory neuroblastoma, is a rare neuroendocrine tumor originating from the olfactory epithelium of the upper nasal cavity and representing < 3% of all tumors of the nasal cavities. This malignant tumor is characterized by a slow growth and local recurrencies and has a more favorable prognosis as compared with other more frequent forms of neuroblastomas originating from the suprarenal medulla and the sympathetic nervous system. Affected patients usually present with a history of progressive nasal obstruction, rhinorrhea, and severe epistaxis--sign of the conspicuous vascularity of this type of tumor. The combined use of CT and MR techniques allows the diagnostic suspicion of esthesioneuroblastoma and is of vital importance in the accurate staging of the disease and in the treatment planning.


Subject(s)
Esthesioneuroblastoma, Olfactory/diagnostic imaging , Magnetic Resonance Imaging , Nasal Cavity , Nose Neoplasms/diagnostic imaging , Tomography, X-Ray Computed , Diagnosis, Differential , Humans , Male , Middle Aged
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