bluuebunny/crossref_metadata_2025_split huggingface dataset:
Encefalopatia di Wernicke: Aspetti RM e revisione della letteratura Segnalazione di un caso
Authors: Angileri T. , Banco A. , Sparacia G. , Pappalardo S. , Manfrè L. 
Published: April 2015

L'encefalopatia di Wernicke è patologia legata a deficit di tiamina, conseguente spesso ad alcolismo cronico, che presenta peculiari localizzazioni encefaliche e conseguenti manifestazioni cliniche. Viene descritto un caso di encefalopatia di Wernicke in un uomo di 25 anni, non alcolista, valutandone le lesioni alla risonanza magnetica in fase acuta e seguendone l'evoluzione. Il paziente, con anamnesi patologica prossima di colite amebica, presentava un progressivo e rapido deterioramento delle capacità cognitive preceduto da una severa ipoacusia e riduzione dell'acuità visiva, discromatopsia, allucinazioni visive, prosopoagnosia, disartria. Viene eseguita una RM dell'encefalo (con apparecchio Vectra, GE, operante a 0,5 T; sequenze SE DP e T2 ponderate e T1, prima e dopo Gd-DTPA) che evidenzia aree lesionali espresse da iperintensità, nelle sequenze a lungo TE, dei corpi mammillari, dei tubercoli quadrigemelli inferiori e (segno semeiologico, per quanto risulta da una revisione della letteratura, non descritto in precedenza tra i reperti dell'encefalopatia di Wernicke) dei tratti ottici. Ad una decisa integrazione alimentare con tiamina segue un repentino miglioramento clinico. Esami RM seriati rivelano una netta riduzione dell'estensione e delle alterazioni dell'intensità di segnale delle aree precedentemente coinvolte fino alla totale normalizzazione dei reperti. Viene discussa la clinica, l'istologia e la presunta patogenesi dell'elettiva localizzazione del danno da carenza di tiamina a carico dell'encefalo, e gli aspetti neuroradiologici, individuando il ruolo dell'RM nell'iter diagnostico di tale patologia.
Idrocefalo normoteso: Valutazione comparativa tra studi di dinamica liquorale mediante TC e RM
Authors: Bonamini M. , Gallucci M. , Simonetti L. , Alagia M.G. , Gagliardo O. , Cardone G. , Paluello G.B. Minio , Castrucci M. 
Published: April 2015

Aim of this study was to evaluate the sensitivity of MR dynamic Bolus Tracking technique versus CT-cysterno graphy in Normal Pressure Hydrocephalus (NPH). Seven patients (age 64–76 yrs), clinically suspected of NPH, were retrospectively evaluated. They had been submitted to CT-cysternography, MR dynamic Bolus Tracking technique in the acqueduct (cardiac-gated flow direction evaluation by means of 12–16 FFE T2*-w acquisitions per cardiac cycle, on sagittal plane along the acqueduct, with presaturation perpendicular to the acqueduct) and finally to surgical evaluation and subsequent ventriculo-peritoneal shunt. MR showed in all cases altered cerebrospinal fluid (CSF) dynamics: 5 patients showed CSF reflux in the third ventricle during all cardiac cycle, in 2 patients an increased ejection rate through the acqueduct and into the cisterna magna was found. CT-cysternography showed CSF dynamics alterations only in 4 cases. MR dynamic Bolus Tracking technique has proven to be more sensitive than CT-cysternography in the evaluation of NPH. Even though this study has to be considered preliminary, we believe that this simple and noninvasive technique should be recommended when NPH is suspected.
Ruolo della risonanza magnetica nella neuropatia periferica canalicolare non traumatica dell'arto superiore
Authors: Lupo F.A. , Paladini A. 
Published: April 2015

La sindrome da neuropatia periferica canalicolare non traumatica è un'affezione relativamente frequente e può rappresentare il risultato di numerose noxe che direttamente o indirettamente agiscono su segmenti di nervo che percorrono canali osteo-fibrosi. In tali strettoie il nervo, struttura più vulnerabile, può subire fenomeni meccanici di frizione o di pressione che, agendo sui vasa nervorum possono produrre ipossia, anossia, ischemia del nervo. Viene riportato lo studio di 31 pazienti affetti da sindromi canalicolari spontanee non traumatiche degli arti superiori. Viene sottolineato il ruolo svolto dalla RM nell'analisi morfologica dei singoli casi, i cui risultati correlati ai reperti clinici ed elettrofisiologici, possono essere utilizzati quale parametro di gravità nella valutazione prognostica e nella programmazione terapeutica della sindrome.
Reperti RM in pazienti con deficit di GH
Authors: D'Amico A. , Caranci F. , Simonetti L. , Zona G. , Salerno M. , Di Maio S. , Cirillo S. , Elefante R. 
Published: April 2015

MR is able to depict anatomic details of the abnormality in hypothalamic-pituitary region. We report the results in 30 prepurbertal, hypopituitary subjects, aged 6 months-14 years. We analyzed: the MR patterns and their distribution in the patients; the prevalence of “birth traumas” in this group; the prognostic value and the ability to relate to clinical and hormonal data of the MR features
Analisi economica del costo dell'indagine RM effettuata con tomografi di diversa intensità
Authors: Coppola V. , Memoli L. , Brunese L. , Alfinito M. , Coppola M. , Vallone G. 
Published: April 2015

Indipendentemente dalle prestazioni, sono stati valutati e confrontati i costi di gestione e di ammortamento di due apparecchiature per risonanza magnetica da 1 e 0,5 Tesla e si è ricavato il costo-medio per esame. Le condizioni lavorative sono state rappresentate in maniera ideale e i tempi tecnici standardizzati. Le nuove modalità di rimborso a prestazione, basata sulla verifica dei DRG deve obbligare a una preventiva valutazione strategica delle risorse da impiegare e dei costi da sopportare ai fini del raggiungimento del break even point. La modalità procedurale seguita deve rientrare nella pianificazione strategica delle risorse che tutte le amministrazioni devono effettuare preliminarmente alla indizione di una gara d'appalto.
Intra-Ocular Lymphoma with and without CNS Involvement: Diagnosis and Follow-up a Report of 15 Cases Studied by MR
Authors: Gerber S. , Reux I. , Cassoux N. , Soussain C. , Fardeau CH. , Deladoeuille M. , Marro B. , Le Hoang Ph. , Marsault C. , Leblond V. 
Published: April 2015

In order to assess the value of MRI in the diagnosis and follow-up of intra-ocular lymphoma, a rare form of primary non-Hodgkin's lymphoma of the central nervous system, we retrospectively reviewed fifteen patients. All patients had ophthalmic investigations and 13 underwent ocular sampling. MR examinations of the brain and globes were performed in all cases and five patients underwent stereotactic brain biopsy. Six patients were treated with chemotherapy and/or radiotherapy, and nine with high-dose chemotherapy, followed by autologous bone marrow transplantation in five cases. MR follow-up was available in all cases. All 15 patients had chronic uveitis which preceded the diagnosis and abnormal funduscopic findings. Three had a mild or severe neurologic deficit. Initial MRI showed brain lymphoma lesions in six cases and a choroido-retinal tumour in one. MR brain lesions were multiple in four cases. They appeared as contrast-enhanced infiltrating areas (n=11) or expansive masses (n=3); two lesions appeared as infiltrating high-signal T2 areas but were unenhanced on T1 with GdDTPA. The diagnosis was based on vitrectomy in 11 cases and on stereotactic brain biopsy in four. Of the twelve lumbar punctures which were performed one was positive. Contrast enhancement disappeared during treatment in all cases, but isolated signal abnormalities persisted. The long-term outcome of such lesions in patients with an intact blood-brain barrier is not yet known. Ocular relapses occurred in 14 patients and CNS recurrences in four. Three patients died from CNS failure (n=1) or relapse (n=2), five are alive in partial remission, five are in complete remission and two died in remission from other causes. Follow-up ranges from 12 to 78 months (median 36 months). MRI usually failed to detect intra-ocular lesions but identified clinically occult brain lesions and served to guide stereotactic brain biopsy when other samples were negative. MRI is the most sensitive follow-up method during treatment, even when the blood-brain barrier is intact.
Morphology and Development of the Spine: Plea for a Doubt
Authors: Roth M. 
Published: April 2015

Growth and development of the vertebral column cannot be understood without taking into account its closest link with the “leading” cogrowth of its neural content. The phylogenetically established degree of outgrowth of that content determines the length of individual vertebrae and of the vertebral envelope in whole. Impairment of spinal neural growth leads to neuroadaptive transformation of vertebral shape in the sense of neuroadaptive shortening. Insufficient spinal neural growth during the developmental period is paralleled by involutional atrophogenic shortening of the spinal nerve roots in the aged with essentially analogous response of the vertebral envelope, viz., profound and sometimes bizarre neuroadaptive “deformities” in the course of development, neuroadaptive “degenerative” narrowing (i.e. shortening) of the disc space(s) in the course of aging. Owing to the craniocaudally proceeding growth in length of the axial organ the neuroadaptive shortening in both instances is accomplished as though “from below”.
Angioplastica carotidea
Authors: Puglioli M. , Padolecchia R. , Collavoli P.L. , Parenti G. , Orlandi G. , Paoli C. 
Published: April 2015

L'endoarteriectomia, come confermano i risultati degli studi multicentrici NASCET (North American Symptomatic Carotid Endarterectomy Trial), ECST (European Carotid Surgery Trial) ed ACAS (Asymptomatic Carotid Atherosclerosis Study), rappresenta il trattamento di elezione delle stenosi aterosclerotiche interessanti il distretto extracranico dell'arteria carotide, sia nei pazienti sintomatici (stenosi > 70%) che asintomatici (stenosi > 60%). L'intervento chirurgico è gravato da un rischio cumulativo di morbilità-mortalità (stroke/morte) che il NASCET, l'ECST e l'ACAS segnalano, rispettivamente, nel 5,8%, 7,5% e 2,3%, insieme ad altre possibili complicanze: infarto miocardico (0,9%), paralisi di nervi cranici (7,6%), ematoma del collo (5,5%), infezioni (3,4%). Qualora, per ragioni cliniche od anatomiche, il rischio chirurgico sia troppo elevato, come nei pazienti cardiopatici, diabetici, con insufficienza polmonare o renale, con restenosi, con stenosi post-attiniche o fibrodisplastiche, con stenosi carotidee prossimali o distali, con lesioni «tandem», l'angioplastica transluminale percutanea (PTA) e/o lo Stenting carotideo possono rappresentare una valida alternativa terapeutica all'endoarteriectomia. In questo articolo presentiamo la nostra casistica relativa a 41 procedure (36 PTA; 5 Stenting), eseguite su 33 pazienti negli ultimi due anni. I trattamenti sono stati rivolti a 28 arterie carotidi interne, 4 arterie carotidi esterne, 2 arterie carotidi comuni, 2 tronchi anonimi; gli stents sono stati rilasciati in 4 arterie carotidi interne e in 1 arteria carotide comune. Le procedure regolarmente portate a termine sono state 37 (32 PTA; 5 Stents), con un ottimo risultato anatomico in 36 casi. Nei controlli a 6 mesi abbiamo riscontrato una ristenosi (< 60%), asintomatica. In questo articolo illustriamo il nostro protocollo, gli insuccessi tecnici, i risultati e le complicanze.
Cerebral Leptomeningeal Angiomatosis CT and MRI evaluation
Authors: Tsitouridis J. , Stamos S. , Demertzis J. , Nikolopoulos P. 
Published: April 2015

Leptomeningeal angiomatosis is an uncommon benign hamartomatous lesion usually involving the leptomeninges with or without cerebral cortex involvement. Three middle-aged patients with seizures from adulthood had undergone CT and MRI examinations and craniotomies which revealed leptomeningeal angiomatosis. Another two young patients with Sturge-Weber syndrome and leptomeningeal angiomatosis were also evaluated. MRI is clearly helpful in establishing the topography and vascular malformative nature of the lesion, while CT is more accurate in detecting vascular calcifications.
Cerebral Venous Sinus Thrombosis: Prognostic and Therapeutic Significance of an Early Radiologic Diagnosis
Authors: Roncallo F. , Turtulici I. , Arena E. , Bisio N. , Inglese M. , Assini A. , Gasparetto B. , Bartolini A. 
Published: April 2015

We describe the CT and MRI patterns of cerebral venous sinus thrombosis (CVST) on the basis of the venous angioarchitecture and the underlying pathophysiological mechanism. We also investigated if any radiologic data exist to establish which patients can be followed conservatively and which warrant endovascular treatment. The clinical, CT-CTA and MRI-MRA findings of 11 patients (2 men; 9 women; 24 to 69 years-old) with CVST were reviewed. The morphological patterns of CVST were divided into two major groups: Vascular signs: spontaneous sinusal hyperdensity (9); spontaneous all-sequences hyperintensity (4); venous engorgement (9); empty delta sign (4); lack of sinusal contrast-enhancement (3); delayed sinusal transit-time (11); lack of flow-related signal (3). Parenchymal signs: mass effect and cortical sulcal effacement (8), white matter edema (7), venous ischemia (6), haemorrhagic infarct (3), breakdown of the blood-brain barrier (4), hydrocephalus (2). The clinical and radiologic pictures are related to cerebral venous angioarchitecture and underlying pathophysiologic mechanism of venous thrombosis. Reversibility of clinical symptoms and parenchymal lesions is far more frequent, because vessel damage slowly and progressively develops, whereas damage to brain tissue occurs later. Consequently, a prompt CT-MRI diagnosis may allow a good prognosis. Treatment using selective sinusal instillation of urokinase is considered only when the patient clinically and radiologically does not improve within the first two weeks after heparinization.
Low Dose Contrast Helical CT in Nodal Staging of Head and Neck Tumours
Authors: Dobrocky I. , Kemka S. , Rohac L. , Hudec P. 
Published: April 2015

The aim of the study is to evaluate the accuracy of helical CT with low dose contrast in the nodal staging of head and neck tumours. Fifty-one patients were included in the study. 1 ml/kg of body weight of 300 mgI/ml contrast was injected at a rate of 1.5 ml/s. The total volume ranged according to the patient's weight between 45 and 100 ml (mean 70 ml). Axial diameter of 15 resp. 10 mm was set as a criterion for malignant involvement. The overall sensitivity for detection of malignant nodes was 92%, specificity 88%, accuracy 90%. The overall accuracy in nodal staging was 90%, sensitivity 96%, specificity 80%. The quality of contrast enhancement was scored with 2.5 on a 3 point scale (1-poor, 2-good, 3-excellent). The sensitivity, specificity and accuracy in detecting metastatic lymph nodes with this technique in patients with head and neck cancer is comparable to studies performed with high dose. The maximal axial diameter of the LN is a suitable parameter for the daily routine.
MR Features of Lissencephaly with Clinical Correlations
Authors: Razek A. Abdel Khalek Abdel , Kandeel A. Y. , Baseet A.M. Abdel 
Published: April 2015

We aimed to demonstrate the MRI features of lissencephaly and to correlate these features with associated anomalies and clinical features in an attempt to classify them. This study included eight infants with lissencephaly. They presented with seizures, hypotonia, microcephaly, large head or failure to thrive. They were examined using a 1.5 Tesla scanner. Both T1 and T2 weighted scan were done. Our patients showed a smooth surface of both cerebral hemispheres with complete loss of gyri and sulci (agyria) (n=5) or agyria with areas of pachygyria (n=3). The cortex was thickened with thinning of the underlying white matter and loss of normal grey-white matter interdigitations (n=8). A shallow Sylvian fissure with hourglass or oval configuration of the brain was also noted (n=8). A linear cortical band of low SI on T1 WI and high SI on T2WI was noted in five cases. Other associated findings included: Dandy-Walker malformations (n=5), hydrocephalus (n=4), microcephaly (n=2), callosal agenesis (n=2), occipital encephalocele (n=1), microphalamia with retinal dysplasia (n=1), absent septum pellucidum (n?1) and colpocephaly (n=1). MR imaging is the imaging modality of choice for the demonstration of the pathognomonic features of lissencephaly. It helps the classification of lissencephaly into different types according to their MR appearance, associated anomalies and clinical features.
MRI Changes in Cerebrotendinous Xanthomatosis after Treatment with Chenodeoxycholic Acid
Authors: Lui C.-C. , Chang W.-N. 
Published: April 2015

We report serial changes in MRI findings in three siblings of biochemically and clinically proven cerebrotendinous xanthomatosis (CTX) after treatment with chenodeoxycholic acid (CDCA) 750 mg/day orally for seven years. Clinical and electrophysiological studies are also assessed. Electroencephalography (EEG) has improved dramatically, whereas the magnetic resonance image (MRI) shows only slight change.
Distribution of White Matter Lesions in Multiple Sclerosis and Systemic Lupus Erythematosus
Authors: Peltz M.T. , Casciu L. , Manconi F.M. , Sanna G. , Schiffini P. , Mathieu A. 
Published: April 2015

To evaluate the ability of brain MRI SE sequences to differentiate between SLE and MS we reviewed the brain scans of 30 SLE patients (30 female, mean age 38.5 +/-12 years) and of 30 definite MS patients (23 female, 7 male, mean age 35.5 +/- 8 years). We analyzed the number and location of white matter lesions (WML) and classified them in different regions. We also pointed out associated brain abnormalities, such as large hemispheric lesions. We found periventricular, paraventricular and subcortical WML in MS and paraventricular and subcortical WML in SLE; a confluent pattern of WML was seen only in MS; infratentorial WML were more frequent in MS; corpus callosum involvement was found only in MS; large hemispheric areas of increased signal representing strokes were present only in SLE. MRI shows different lesion patterns in MS and SLE and may play an important role in the differential diagnosis between these diseases.
Improved MRI Depiction of Intracranial and Spinal Cord Vascular Lesions Using Thin Section FSE T2 Imaging Sequences
Authors: Noonan P.T. , Richardson A.C. , Hsieh H. , Depper M.H. , Stockel J.B. 
Published: April 2015

Conventional MR and MRA techniques may not accurately depict intracranial and spinal vascular anatomy and pathology. By relying on the intravascular signal void of flowing blood and the ability to obtain contiguous images, thin section FSE T2 imaging techniques including three dimensional imaging improve depiction of vessels and increase diagnostic accuracy. The images produced by these techniques both compliment MRA and correlate well with findings at catheter-based diagnostic angiography. A pitfall is the imaging of vascular structures adjacent to nonvascular structures also having signal voids. As in other MR techniques differentiation between slow flow and occlusion may be difficult.
Changes in Cerebral Perfusion after Osmotherapy in Acute Cerebral Stroke Measured by Perfusion-Weighted MRI
Authors: Hagen T. , Stoll M. , Bartylla K. , Treib J. , Piepgras U. 
Published: April 2015

We investigate the hemodynamic changes after osmotherapy in patients with acute cerebral stroke. Measurement of mean transit time (MTT), regional cerebral blood volume (rCBV) and regional cerebral blood flow (rCBF) with perfusion-weighted MRI. During a bolus injection of 0.1 mmol/kg Gadolinium-DTPA a series of transversal T2*-weighted FLASH-images was recorded. Based on the indicator dilution theory MTT, rCBV and rCBF were calculated and displayed in a parameter map. In 11 patients showing local brain edema caused by cerebral infarction this technique was applied before and 30 minutes after intravenous infusion of 125 ml of 40% sorbitol. Before treatment eight patients showed pronounced inhomogeneous distribution of MTT and rCBV with increased rCBV ipsilateral to the lesion. rCBF was only slightly reduced in the ipsilateral hemisphere. After treatment the side to side differences of rCBV and MTT were significantly (p<0.05) reduced. Perfusion-weighted MRI appears as a suitable method to assess the hemodynamic changes in patients with cerebral stroke. rCBV seems to be more influenced by acute locale brain edema than rCBF. The elevation of rCBV and MTT can be explained by an impaired, but compensated perfusion, which normalizes after osmotherapy.
Osservazione dell'attivazione neuronale con RM Studio della sequenza di acquisizione
Authors: Longo R. , Rossi M. , Ukmar M. , Zanier F. , Pozzi-Mucelli R.S. 
Published: April 2015

Lo studio dell'attivazione neuronale con RM funzionale (fMRI) è una delle tecniche che si va affermando sia nella pratica clinica che nella ricerca di neuroscienze. La non-riproducibilità quantitativa dei risultati pubblicati (numero di pixel attivati, intensità relativa del segnale) ha indotto gli autori ad un'analisi sistematica dei parametri di acquisizione per comprendere il loro effetto sulle mappe di attivazione, nel presente studio mappe di attivazione della corteccia motoria e visiva. è stata inoltre verificata l'importanza del contributo degli effetti di flusso nella microvascolatura alle mappe di attivazione. Gli studi si sono svolti complessivamente su 21 volontari sani. I parametri di acquisizione che sono stati presi in esame sono i seguenti: tempo di eco, spessore della fetta, angolo di flip, omogeneità di campo, orientazione spaziale delle fette. Si è quindi scelto un protocollo ritenuto ottimale per l'applicazione della tecnica di fMRI in ambiente clinico con un tomografo a 1,5 T: TE = 40 ms, TR = 60 ms, flip angle = 25°, spessore di strato = 4 mm, matrice di acquisizione = 128 × 128, matrice di ricostruzione = 256 × 256, compensazione per gli artefatti da flusso, tecnica di contrast enhancement = T1.