bluuebunny/crossref_metadata_2025_split huggingface dataset:
Le sequenze Turbo-FLAIR nell'analisi volumetrica ippocampale nell'epilessia temporale farmaco-resistente
Authors: Ferone E. , Pierallini A. , Piattella M.C. , Bozzao A. , Prosperi D. , Giallonardo A.T. , Fantozzi L.M. , Bozzao L. 
Published: April 2015

Scopo del lavoro è stato quello di valutare eventuali alterazioni della intensità di segnale e di volume della regione ippocampale in pazienti affetti da epilessia temporale farmaco-resistente utilizzando sequenze Turbo-FLAIR (Fluid Attenuated Inversion Recovery) e sequenze volumetriche pesate in T1. A tale scopo abbiamo studiato 40 pazienti affetti da epilessia temporale farmaco-resistente utilizzando un apparecchio RM da 1,5 TESLA (NT 15 Philips «Gyroscan»). Sono state utilizzate sequenze Spin-Echo convenzionali, Turbo Spin-Echo, Inversion Recovery, Turbo-FLAIR e sequenze 3D volumetriche sui piani coronali, sequenze Spin-Echo convenzionali sui piani assiali e sagittali. L'intensità del segnale ed il volume della regione ippocampale sono stati valutati mediante analisi semi-quantitative automatiche eseguite con una workstation SUN. Abbiamo riscontrato una differenza significativa dei valori dell'intensità di segnale dei due ippocampi in 22 pazienti utilizzando le sequenze FLAIR. In 8 di questi pazienti non erano invece presenti differenze significative con le sequenze Spin-Echo convenzionali e Turbo Spin-Echo. L'analisi volumetrica ha mostrato un assottigliamento della corteccia dell'ippocampo in 12 dei 22 pazienti che presentavano anomalie dell'intensità del segnale. I dati del presente studio suggeriscono una maggiore sensibilità delle sequenze Turbo-FLAIR nell'evidenziare alterazioni dell'intensità di segnale della regione dell'ippocampo.
Is Digital Subtraction Angiography Still the Method of Choice for Diagnosis and Follow-up of Cervical Artery Dissection?
Authors: Roncallo F. , Turtulici I. , Arena E. , Colucci M. , Gasparetto B. , Bartolini A. 
Published: April 2015

Cervical Artery Dissection (CAD) accounts for up to one fifth of ischaemic strokes occurring before 45 years. The internal carotid artery is the most commonly affected vessel. Cerebral ischemia is the most serious consequence of carotid artery dissection. The enlargement of the artery may lead to laterocervical pain and direct compression of the lower cranial nerves and/or sympathetic peri-carotid plexus. A spontaneous dissection is assumed when no or only minor trauma preceded the onset. The pathogenesis of dissections remains unknown in most cases, but traumas and primary diseases of the arterial wall are the main predisposing factors. We monitored six patients with CAD (four males, two females; 32–67 years old). All patients underwent US and CT-CTA examinations; five patients had DSA; four patients underwent MRI-MRA within the first two weeks after clinical onset. Four patients have received intravenous heparin treatment followed by oral anticoagulant therapy. Patients were then followed up with US alone (3 patients) or combined with CTA (3 patients) at 3 months to 2 years. Three patients demonstrated a completed stroke in the middle cerebral artery territory (two patients) and in the posterior inferior cerebellar artery territory (one patient). Five patients had headache and/or cervicofacial pain. One had only neck and brachial pain. Four patients showed a Horner's syndrome alone (two patients) or associated with 9th, 10th, 11th and 12th cranial nerve involvement (one patient) or associated with stroke (one patient). One patient had brachial plexus motor impairment. Four patients had ICA dissection; one patient had VA dissection; one patient had multiple neck vessel dissection, that were correctly demonstrated by CTA and DSA in all cases. In five cases US overestimated the stenosis, showing a false occlusion pattern. MRI-MRA well displayedmural haematoma in the subacute stage, ipsilateral reduced intracranial blood flow and brain damage. CADs are treated by heparin at the acute stage, although the benefit of such a potenially dangerous treatment has never been proven by a randomized trial. The favorable natural history of CAD emphasizes the need for a non-invasive approach to detection, monitoring and follow-up. A combined morphological and functional analysis of the brain and neck arteries is mandatory. Consequently DSA may be now replaced by US, MRI-MRA and CT-CTA. Because the three sets of CTA images correctly depict arterial wall and lumen without flow artifacts, this technique may be considered the new gold standard for the assessment of CAD.
Le Spondilodisciti in età pediatrica
Authors: Salviati L. , Monciotti C. , Turra S. , Gigante C. , Dei Rossi A. , Amistà P. , Carollo C. 
Published: April 2015

La spondilodiscite è un processo infiammatorio a carico del disco vertebrale con variabile interessamento dell'osso confinante. è una patologia, benché rara, tipica dell'età pediatrica, la cui reale incidenza non è nota. L'eziologia è infettiva nella maggior parte dei casi, i segmenti più colpiti sono soprattutto le vertebre lombari, la via di diffusione è per lo più ematogena, a differenza delle forme dell'adulto, prevalentemente secondarie a manovre chirurgiche. La ricca vascolarizzazione disco-vertebrale nell'infanzia rende conto delle peculiari caratteristiche di questa patologia. I sintomi iniziali sono spesso aspecifici (febbre, dolore, disturbi della deambulazione), rara la leucocitosi, quasi costante l'elevazione degli indici di flogosi, emocoltura positiva in meno del 30% dei casi. 7 casi seguiti presso il nostro centro negli ultimi 8 anni. La diagnosi è stata posta mediante radiologia tradizionale, TC, RM in tutti i casi, e in 3 pazienti anche con biopsia TC-mirata, con follow up da 1 a 10 anni. La spondilodiscite in età pediatrica è una patologia a prognosi favorevole, la RM è determinante per la diagnosi, il controllo a distanza è indicato per la valutazione degli esiti: ridotto accrescimento encondrale, cifosi focale, fusione intervertebrale.
Evaluation of Multiple Sclerosis Disease Activity by Diffusion-Weighted MR Imaging Preliminary Comparison with Contrast-Enhanced MR Imaging
Authors: Tsuchiya K. , Yoshino A. , Katase S. , Hachiya J. 
Published: April 2015

The purpose of this study was to assess the utility of cerebral diffusion-weighted MR imaging in the diagnosis of multiple sclerosis (MS) in comparison with contrast-enhanced T1-weighted imaging. We reviewed T2-weighted spin-echo (SE), fluid-attenuated inversion-recovery (FLAIR), contrast-enhanced T1-weighted SE and echo-planar diffusion-weighted images (DWIs) obtained in ten patients with definite MS on 12 occasions. In total, 83 plaques were demonstrated on T2-weighted SE and/or FLAIR images. Thirteen of these plaques showed enhancement on contrast-enhanced T1-weighted images and hyperintensity on DWIs. Five non-enhancing plaques showed hyperintensity on DWIs. Diffusion-weighted imaging, which provides information based on pathophysiology different from contrast-enhanced imaging, is a potential supplementary technique for characterizing MS plaques.
MR and CT Findings in Cavernous Sinus and Tributary Veno-Sinus Thrombosis
Authors: Schuknecht B.F. , Yüksel C. , Valavanis A. 
Published: April 2015

We demonstrate cavernous sinus thrombosis and tributary veno-sinus thrombosis by high resolution CT and MR. Thin section (2mm) contrast enhanced high resolution CT scans obtained in eight patients with a diagnosis of a cavernous sinus thrombosis were compared to 30 normal controls. In six patients CT scans were compared to 3-D spoiled gradient-recalled acquisition in the steady state (SPGR) sequences. Contrast enhanced CT of the cavernous sinus in eight patients differed from normal controls with respect to the size of filling defects that exceeded 7 mm in 78.6% of patients compared to 9.1% of controls. Thrombus formation accounted for a mean density of 26.7 ± 7.8 HU compared to −1.1 ± 12.3 HU in controls. Expansion of the cavernous sinus due to thrombosis was indicated by a significant increase in diameter (mean 10.8 mm) vs 8.3 mm in controls. Tributary veno-sinus thrombosis affected the superior ophthalmic vein and the inferior petrosal sinus in four patients each and the sphenoparietal sinus in two patients. Thin — section CT and the contrast — enhanced SPGR MR sequences were equally suited to recognize cavernous sinus and tributary veno-sinus thrombosis. High resolution CT and MR findings indicate that tributary veno-sinus thrombosis not only affects the superior ophthalmic vein but may be more common than previously assumed.
CT and MRI Findings of Central Neurocytoma
Authors: Kong S.-C. , Chen C.C.-C. , Shen Wu-Chung , Lee S.-K. , Wen M.-C. 
Published: April 2015

Central neurocytoma (CN) is a rare but usually benign cerebral intraventricular tumor of young adults which can be confused with oligodendroglioma and other neoplasms. A retrospective review of the CT and MRI findings in five pathologically confirmed cases shows that CN frequently demonstrates a characteristic attachment to the septum pellucidum and confinement to the lateral and third ventricles. The tumor presented as a hypo-, iso- or hyperdense mass on CT, a low, iso- or high-signal intensity on T1WI, and a high-signal intensity on T2WI when compared to the brain gray matter with mild to moderate contrast enhancement. No tumor contained calcification, and only two of them showed cyst-like areas. In one case, hemorrhage was present in both the tumor and the ventricles. The results indicate that CN can still be suggested radiologically and does not necessarily contain calcification or cyst-like areas. Preoperative diagnosis of CN may prove of value for planning therapy, because this tumor seems to have a better prognosis than other intraventricular tumors.
CT and MR Features of Multiple Gliomas
Authors: Lafitte F. , Precetti S. , Martin-Duverneuil N. , Piotin M. , Guermazi A. , Brunet E. , Spelle L. , Chiras J. 
Published: April 2015

We analysed the CT and MR features of multiple gliomas, and determined the best imaging modality for the initial diagnosis. CT (seven scans) and MR imaging (nine scans) of nine patients with proven multifocal malignant gliomas were reviewed by two neuroradiologists. The lesions were usually hypodense on CT (64%), hypo or isointense on T1-W images (81%), and hyperintense on T2-W images (95%). Edema and mass effect were usually moderate or absent. After contrast media administration, the enhancement was mostly strong (64% on CT and 81% on MR), often heterogenous. MR features of the different lesions in one patient were often different (67%). Meningeal enhancement, suggestive of a possible way of dissemination, was rare. MR allowed detection of six lesions overlooked by CT. In the case of multiple cerebral masses, multiple gliomas should be considered as a possible diagnosis as well as brain metastases, abcesses or multifocal lymphomas. Moderate edema and mass effect associated with strong and heterogenous enhancement are evocative. MR is more sensitive than CT for the detection of the lesions, but rarely allows visualization of a dissemination route.
Collateral Capacity of the Circle of Willis in Patients with Planned Sacrifice of the Internal Carotid Artery
Authors: Schumacher M. , Hetzel A. , Von Reutern G.-M. , Wernz M. G. , Droste D. W. 
Published: April 2015

To evaluate the accuracy of Doppler sonography compared with angiography, temporary test occlusion of the internal carotid artery (ICA) was performed as paramenter for prediction of tolerance in case of sacrifice of the ICA. The vessel occlusion was done in 67 patients by manual compression over 10 seconds and by twenty minutes lasting balloon insufflation. The results (table 1) show a good correlation between dopplersonographic and angiographic testing in terms of collateral circulation. However, Doppler sonography proved to be more indicative for predicting clinically insufficient collateral supply.
Cerebral Venous Thrombosis: Relations between the Extension of the Thrombosis and Parenchymal Damage
Authors: Bergui M. , Bradac G.B. , Daniele D. , Gozzoli L. , Stura G. 
Published: April 2015

Prognosis of cerebral venous thrombosis (CVT) changed in recent years from a life-threatening to a more benign condition. Anticoagulation therapy “freezes” the evolution of the disease, preventing progression to extensive brain lesions. Good outcomes reveal a wide range of lesions; moreover, neuroradiological investigations allow a precise evaluation of dural sinuses and deep venous system. With this background we tried to correlate the extension of the thrombosis in dural sinuses and deep venous system with the brain lesions in 24 patients with CVT and found no clear correlation. On the other hand, in particular cases a relation between thrombosis of cortical veins or deep medullary veins and brain lesions was found. The availability of alternative venous drainage probably explains the different extension of brain lesions in our patients. According to data from the literature cortical and deep medullary veins may represent “critical” locations for collateral venous circulation in CVT.
Hemodynamic Effects of Middle Cerebral Artery Stenosis and Occlusion
Authors: Derdeyn C.P. , Powers W.J. , Grubb R.L. 
Published: April 2015

Middle cerebral artery (MCA) stenosis and occlusion may cause ischemic symptoms through both hemodynamic and embolic mechanisms. The purpose of this investigation was to determine the hemodynamic effects of these lesions. Ten patients with angiographically confirmed symptomatic occlusion (n ? 5) or stenosis (n = 5) of the Ml segment of the MCA were studied with clinical evaluation, arteriography, and positron emission tomography (PET). Hemodynamic status was categorized by PET as: Stage 0, normal hemodynamics; Stage 1, autoregulatory vasodilatation (increased MTT); and Stage 2, increased OEF. Of five patients with MCA occlusion, three had autoregulatory vasodilatation (Stage 1) and 2 demonstrated increased OEF distal to the lesion (Stage 2). The MCA territory was supplied solely by pial collaterals in all five patients. Four of the five patients with focal MCA stenosis had normal hemodynamics (Stage 0). One patient was categorized as Stage 1. The frequency of hemodynamic compromise in patients with MCA occlusion is high. Pial collateralization is not a specific sign of increased OEF in patients with MCA occlusion.
Il ruolo diagnostico-terapeutico della terapia infiltrativa antalgica nelle sindromi algiche di origine lombare
Authors: Ferrito G. , Scazzeri F. , Prosetti D. , Augusti A. , Marconi F. , Cantini R. , Lepori P. , Salvadori R. , Quilici N. 
Published: April 2015

La notevole incidenza del dolore lombare costituisce spesso un problema sia diagnostico, relativamente alla ricerca della causa dolore, che terapeutico per quanto concerne l'indicazione al trattamento più idoneo. Infatti il successo del trattamento dipende da una accurata diagnosi ma è spesso difficile trovare una diretta correlazione tra sintomatologia clinica e tipo di processo patologico. Varie sono le cause, rachidee ed extra-rachidee di dolore lombare eventualmente irradiato agli arti inferiori, ma le faccette articolari interapofisarie sono certamente le maggiori responsabili. Riportiamo la nostra esperienza nel trattamento, antalgico, ambulatoriale del dolore di origine vertebrodiscale con blocco farmacologico anestetico-cortisonico delle faccette articolari posteriori e con infiltrazione epidurale per via sacrale. Si sottolinea anche il valore diagnostico del blocco anestetico delle faccette articolari.
Atypical Magnetic Resonance Features of Intracranial Meningioma
Authors: Tsitouridis J. , Demertzis J. , Karidas M. , Papastergiou C. , Kosmatopoulos F. 
Published: April 2015

A small number of intracranial meningiomas have atypical MR appearance which can lead to misdiagnosis. We present the MR features of 14 atypical meningiomas. Meningiomas characterized as atypical either because of their MR features (extensive necrosis, association with large cysts or neoplasms, haemorrhage, scarring) or their location (intradiploic, intraventricular, extradural extension). Four cases (28,5%) were misdiagnosed initially as other lesions based on MR findings alone. In all cases with MR atypicality the diagnosis was confirmed surgically.
Meningeal Carcinomatosis of the Cerebellopontine Angle and Internal Auditory Canal
Authors: Duca S. , Salzedo E. 
Published: April 2015

Most CPA and IAC region neoplasms are benign. Malignant tumour represent about 2% of the lesions and metastatic lesions account for 0.2 to 2% of all neoplasms of this region. In a group of 82 patients with meningeal carcinomatosis, 11 patients (16%) with PCA and IAC metastatic lesions were identified. In three cases the original tumour was a breast carcinoma, while in the other eight cases it was a sarcoma, PNET, glioma, leukaemia, lymphoma, medulloblastoma and one tumour of unknown origin. In five cases both PCA and IAC presented abnormal contrast enhancement of nodular type; in four patients only IAC and in two only PCA were involved. IACs were involved bilaterally or monolaterally in four cases each, while PCAs presented bilateral involvement in five cases and monolateral in one. In two cases bilateral Vth cranial nerves and cavernous sinuses were present and all the patients had dural or leptomeningeal carcinomatosis outside the PCAs and IACs. Unlike literature reports in which only 25% of IACs carcinomatosis have a negative clinical picture, we found clinically tested hearing pathology, in only 1/11 patients, and involvement of other cranial nerves in only 2/11 patients. From the MR point of view, CPA and IAC carcinomatosis is characterized by bilateral or, less frequently monolateral nodular or linear contrast enhancement inside the IAC and along the dural lining of the CPA and it usually not visible in non contrast SE T1 and T2 sequences. Carcinomatosis is always associated with more diffuse dural or leptomeningeal secondary neoplastic involvement, but the association with other cranial nerve carcinomatosis is not the rule. The more frequent involvement of these regions may depend on the length of the VIIth and VIIIth cranial nerves (and this observation may also explain the more frequent association with Vth cranial nerve carcinomatosis) and on the volume of the CPA cistern, that allows a more diffuse and longer contact between the nerves and the meninges and the metastatic lesions floating in the cerebrospinal fluid.
Magnetic Resonance Myelography at 0.5 T
Authors: Micheli C. , Gallucci M. , Cardone G. , Gagliardo O. , Paluello G.B. Minio , Castrucci M. 
Published: April 2015

The aims of this study were to evaluate the clinical usefulness of magnetic resonance myelography (MR-M), to suggest technical improvements and to evaluate the results obtained by comparing them with conventional MRI and conventional myelography. A series of 14 healthy volunteers and 43 patients with myelinic or radicular disease were studied by conventional MR and MR-M on an 0.5T unit using sequences pre-optimized for the acquisition of myelographic images. MR-M did not modify the diagnosis made by conventional MRI in cases of myelinic or radicular compression, but it did provide useful additional information in 38% of cases. It provided no additional information on compressive disease. Similar results in terms of quality of information were obtained from the correlation with conventional myelography. In our opinion, MR-M is useful only for cases of discal or spondylogenetic disease.
Organizzazione della corteccia somato-sensoriale secondaria
Authors: Tartaro A. , Antonazzo R. , De Matthaeis P. , Del Gratta C. , Della Penna S. , Ferretti A. , Torquati K. , Colosimo C. , Romani G. 
Published: April 2015

Localizzare e possibilmente evidenziare l'organizzazione somatotopica delle aree somatosensoriali secondarie (SII) con risonanza magnetica funzionale (fMRI) mediante stimolo elettrico applicato agli arti superiori e inferiori. 9 soggetti normali (età media 31 anni), previo consenso informato, sono stati addestrati a rimanere immobili (evitando anche i movimenti oculari) e rilassati sia nella fase di assenza (rest) che di somministrazione (task) di uno stimolo elettrico pulsato della durata di 200 (sec, applicato mediante elettrodi Cu/Sn al polso ed al malleolo interno, unilateralmente. La frequenza dello stimolo è stata di 1,9 stimoli/s. Sono stati stimolati i nervi misti cutanei e propiocettivi mediano e tibiale destro e sinistro. Le immagini funzionali sono state acquisite con tecnica eco-planare in grado di fornire 22 strati contigui, di 3 mm di spessore (matrice 128 × 128) in 2 sec, posizionati parallelamente al piano bicommissurale, dal vertice fino al giro temporale superiore incluso. Il paradigma prevedeva 6 fasi (3 di rest e 3 di task) di 10 acquisizioni ciascuna con delay di 4,5 s. In tutti i soggetti sono state evidenziate aree di attivazione corticale a livello parietale controlaterale all'arto stimolato (aree somatosensoriali primarie e associative). Un significativo aumento di segnale è stato localizzato nel margine superiore della scissura silviana, sia ipsi che controlaterale. La fMRI è in grado di rilevare l'attivazione della corteccia somatosensoriale primaria durante stimolazione elettrica periferica. L'aumento di segnale rilevato nel piede della corteccia parietale, nel tratto corrispondente al margine superiore della scissura silviana, riflette l'attivazione dell'area SII.
Immunoscintigrafia con frammenti anticorpali monovalenti anti-granulociti marcati con 99m Tc: aspetti diagnostici in un caso di ascesso cerebrale
Authors: Dimonte M. , Di Pierro G. 
Published: April 2015

Per tipizzare con relativa sicurezza una lesione cerebrale focale, è spesso necessario integrare TC e RM con tecniche funzionali di imaging quali quelle scintigrafiche. Nel presente lavoro riportiamo un caso in cui l'accertamento definitivo, non invasivo, di un ascesso cerebrale complicante una otite media colesteatomatosa omolaterale, è avvenuto mediante SPECT cerebrale con frammenti Fab' monoclonali anti-granulociti marcati con 99mTc (LeukoScan). Mentre l'impiego in campo neurochirurgico della tradizionale scintigrafia con leucociti autologhi è ben documentato, non abbiamo invece potuto riscontrare in letteratura casi di infezioni cerebrali diagnosticate mediante immunoscintigrafia. La semplice e rapida marcatura in vivo dei granulociti neutrofili mediante frammenti Fab' di anti-corpi specifici per l'antigene di membrana NCA-90 (LeukoScan), rende tale metodica immunoscintigrafia una valida alternativa alla complessa e poco disponibile leucoscintigrafia, e fa prevedere possibili interessanti applicazioni anche in ambito neurochirurgico.