bluuebunny/crossref_metadata_2025_split huggingface dataset:
Il ruolo dell'Angio TC spirale nella valutazione diagnostica della biforcazione carotidea
Authors: Floris R. , Bozzao A. , Mulas M. , Apruzzese A. , Salvatore C. , Simonetti G. 
Published: April 2015

Il ruolo della Angio TC spirale nella valutazione diagnostica della biforcazione carotidea per la selezione di pazienti da sottoporre ad endo-arterectomia è ancora da definire. Lo scopo del nostro studio è quello di valutare l'accuratezza dell'Angio-TC spirale rispetto all'Angiografia carotidea. Abbiamo sottoposto ad Angio-TC spirale dei vasi epiaortici 46 pazienti (92 biforcazioni carotidee) entro 48 ore dall'esame angiografico, utilizzando un apparecchio TC spirale con tubo ad elevate prestazioni (Philips Tomoscan SR 7000). E' stato utilizzato un bolo di contrasto di circa 120 cc con 3 mm di spessore e 3 mm di avanzamento (Pitch=l) ottenendo immagini ricostruite sul piano assiale di 1 mm successivamente elaborate con algoritmo MIP. L'Angiografia carotidea è stata eseguita in almeno due proiezioni per ciascuna biforcazione carotidea ed il grado della stenosi valutato secondo i criteri NASCET. La concordanza tra Angio-TC spirale ed Angiografia carotidea è stata di circa il 90% con minore correlazione per le stenosi di grado lieve e moderato. L'Angio-TC è risultata superiore nella rilevazione di placche calcifiche.
Analisi della tecnica Angio-TC-3D nello studio delle steno-occlusioni carotidee
Authors: Cimino C. , Chiapparini L. , Bruzzone M.G. , Ciceri E. , Carriero M.R. , Lombardi B. 
Published: April 2015

L'angio-TC e le tecniche di ricostruzione tridimensionale su work-station sono strumenti che permettono di studiare la patologia steno-occlusiva dei vasi al collo, ottenendo informazioni sulla morfologia, sull'estensione delle placche ateromasiche e sull'entità delle stenosi. Mentre appare sempre più emergente il ruolo dell'angio-TC come esame di screening per tale patologia, in letteratura non vi è unanimità di giudizio sulla possibilità che questa tecnica, da sola o in associazione con altre non invasive, possa sostituire l'angiografia in previsione di un intervento chirurgico. Scopo di questo lavoro è analizzare la sensibilità, la specificità e l'accuratezza diagnostica di questa tecnica, comprensiva delle successive elaborazioni con programmi di ricostruzione tridimensionale, rispetto a metodiche più tradizionali quali l'angio-RM, l'eco-color-doppler, l'angiografia digitale. Dato il prevedibile aumento di richiesta di esecuzione di questo esame saranno inoltre presi in considerazione altri parametri. In primo luogo sarà considerato il rapporto tra il tempo complessivo dedicato sia all'esecuzione dell'esame (impostazione dei protocolli di acquisizione, scelta della regione di interesse, scelta dei corretti parametri di somministrazione del bolo) sia l'elaborazione delle immagini (scelta del programma di ricostruzione, del target, eventuale segmentazione) e la qualità e l'affidabilità del risultato rispetto ad altre tecniche. Verrà infine considerato il costo biologico dell'esame in termini di dose somministrata al paziente. Data la recente installazione presso il nostro servizio di un'apparecchiatura TC spirale e di work-station per elaborazioni 3D, MIP, MPR, etc., ci proponiamo di utilizzare per questo studio un campione di 20 pazienti con TIA o minor stroke. Tutti questi pazienti saranno sottoposti ad eco-color-doppler, angio-TC, angio-RM e angiografia digitale.
Angio-TC degli aneurismi: Certezze e controversie
Authors: Tamarozzi R. , Ceruti S. , Calzolari F. , Saletti A. 
Published: April 2015

The role of CT-Angiography (CTA) in the diagnosis of cerebral aneurysms has not been definitively established. It depends mainly either on the low spreading of helical-CTs and on the quality of the reconstructive techniques in different equipment. Aim of this paper is to discuss certainties and controversies in the use of CTA in the diagnosis of cerebral aneurysms. CTA can be performed in conjunction with conventional CT with minimal additional scanning time, mainly important in emergency. CTA well-defines shape, size and orientation of the aneurysm, if the scans are free of artefacts and if it is possible to well subtract bones and veins. Technology improvements are awaited in the near future to shorten the time of acquisition, increasing the volume acquired and reducing artefacts. The use of multi-array systems of acquisition, more powerful algorithms to reduce artifacts and software able to define correctly the time of injection of the contrast medium could help to reach the goal of showing all the brain arteries free of artefacts and superimposed veins. At present CTA can substitute angiography in emergency when there is no time to perform angiography and when there is CTA evidence of an aneurysm associated with local haematoma.
Radioterapia stereotassica versus radioterapia convenzionale nel trattamento dei tumori cerebrali
Authors: Ruggiero R. 
Published: April 2015

Steiner nel 1968 iniziò ad applicare la radiochirurgia stereotassica nel trattamento delle malformazioni artero-venose mediante l'erogazione di una singola alta dose di radiazioni concentrata sul bersaglio. Le lesioni suscettibili di tale trattamento non potevano avere diametro superiore a mm. 18. Il progresso tecnologico che si è avuto nell'ultimo decennio con la possibilità di predisposizione dell'acceleratore lineare alla metodica stereotassica e l'utilizzazione di caschi non invasivi, ha reso possibile l'inserimento di questo tipo di radioterapia nel protocollo terapeutico di lesioni encefaliche neoplastiche di differente neura. La radioresistenza della maggioranza di questi processi espansivi limita l'efficacia biologica della radioterapia convenzionale a dosi frazionate, in quanto con questa metodica non è possibile erogare dosi superiori a 60 Gy senza produrre danni notevoli al tessuto cerebrale sano. Viceversa, l'utilizzo di un sistema stereotassico non invasivo e l'impiego di più isocentri consente attualmente l'erogazione di più dosi singole meno elevate, permettendo così l'aggressione di lesioni piuttosto estese e geometricamente complesse. In questo lavoro viene presentata la nostra esperienza nell'applicazione della radioterapia stereotassica, iniziata nel giugno 1991, e vengono poste alcune considerazioni sui vantaggi e sui limiti attuali di questa metodica.
Pseudotumor orbitario: Semeiotica TC-RM e diagnosi differenziale
Authors: Roncallo F. , Turtulici I. , Bandini F. , Mazzella A. , Giberti L. , Calautti C. , Bartolini A. 
Published: April 2015

Lo Pseudotumor Orbitario (PO) viene definito come un processo flogistico aspecifico ed idiopatico per il quale non è possibile identificare una causa locale o riscontrare una patologia sistemica. Si può manifestare clinicamente in diversi modi a seconda delle strutture anatomiche orbitarie coinvolte e la sintomatologia è comunque del tutto aspecifica. Scopo del lavoro è identificare le diverse varianti di PO, con particolare riguardo alla diagnosi differenziale con altra patologia, specie quella neoplastica. Sono stati valutati retrospettivamente 50 esami TC ed RM mirati sulle regioni orbitarie, in pazienti affetti da patologia non traumatica, responsabile della sintomatologia. Successivamente abbiamo stratificato gli esami a seconda della struttura anatomica prevalentemente coinvolta: 1. Loggia lacrimale (8 casi); 2. Muscolatura estrinseca oculare (14 casi); 3. Complesso nervo ottico-involucri meningei del nervo (12 casi); 4. Vena oftalmica superiore (7 casi); 5. Apice orbitario (5 casi); 6. Tessuti orbitari retrobulbari (3 casi). Ognuna di queste diverse strutture può essere selettivamente interessata dallo PO. Per quanto concerne la diagnosi differenziale sono stati riscontrati: 1. Loggia lacrimale: PO (4), Linfoma (2), Flogosi settica (2); 2. Muscolatura estrinseca oculare: PO (6), Oftalmopatia Base-dovviana (5), Metastasi (2); 3. Complesso nervo ottico-involucff meningei del nervo: PO (4), Malattie autoimmuni (4), Meningioma (2), Linfoma (1), Glioma (1); 4. Vena of ialmica superiore: PO (1), Fistola carotido-cavernosa (3), Varice orbitaria (3); S. Apice orbitario: PO (2), Metastasi (2), Meningioma (1); 6. Tessuti orbitari retrobulbari: PO (1), Linfoma (1), cellulite settica (1). Lo PO rappresenta una frequente causa di lesione organica orbitaria dell'adulto. La diagnosi differenziale di natura con altra patologia non sempre è facile su pura base morfologia ed anche la biopsia può fornire dati incerti, specie per quanto riguarda la differenziazione dal linfoma. Emerge quindi l'utilità di restringere al massimo il campo delle ipotesi diagnostiche, unito al criterio ex-adiuvantibus della risposta allo steroide, limitando l'accertamento istologico ai casi non rispondenti.
Stadiazione e controllo dei carcinomi del rinofaringe
Authors: Roncallo F. , Turtulici I. , Giberti L. , Bartolini A. 
Published: April 2015

Prognosis and treatment of Head and Neck tumours (HNT) are correctly planned if the analysis of their grading is accompanied by a careful neuroradiologic study of their spatial extension, lymph node involvement, before and after radiotherapy (RT). CT and MRI are suitable devices for this purpose, since they can help in studying an anatomical region which is difficult to visualize with endoscopy. Aim of the present study is to evaluate the parameters to be considered staging of HNT also after therapy. 25 patients, aged between 26 and 73 years, underwent CT and MRI before and after radiotherapy, alone or associated with chemotherapy. Standard TNM classification was used. T evaluation considers spatial extension to mucosal, descending, ascending, lateral, posterior, perineural, perivascular spaces of the primary lesion; N considers side, borders and location of the involved lymph nodes; after treatment, these two parameters evaluate size reduction and iatrogenic modifications in the tumour mass and lymph nodes.
Angio-RM post-trattamento delle malformazioni vascolari spinali
Authors: Ferrito G. , Mascalchi M. , Scazzeri F. , Prosetti D. , Petruzzi P. , Tessa C. , Mangiaelco S. , Cosottini M. , Quilici N. 
Published: April 2015

Twenty-five patients with spinal vascular malformations demonstrated by spinal arteriography (21 dural arteriovenous fistulas, 2 perimedullary arteriovenous fistulas and 2 intramedullary arteriovenous malformations) underwent MR imaging and contrast enhanced phase-contrast MR angiography before and after endovascular (n?18) or surgical (n=7) treatment. In 3 patients with dural arteriovenous fistula treated with glue embolization, early post-treatment MR angiography showed persistence of flow in the perimedullary vessels. The patency of the fistula was confirmed by spinal arteriography or surgery in all three patients. In two other patients with dural arteriovenous fistulas treated with glue injection, delayed MR angiography showed flow in perimedullary vessels which was not observable in early post-treatment MR angiography controls. Reopening (“recurrence”) of the fistula was confirmed by arteriography in one patient. In the remaining 16 patients with dural arteriovenous fistula, post-treatment MR angiography showed disappearance of flow in the perimedullary vessels consistent with obliteration of the fistula. This finding was associated with persistent intramedullary signal changes and contrast enhancement in 13 patients and perimedullary contrast enhancing vessels in 6 patients. Arteriography in one of the latter patients showed exclusion of the fistula confirming the result of the posttreatment MR angiography study. In the 4 patients with high flow spinal vascular malformations, all treated with endovascular approach, early post-treatment MR angiography showed reduction or disappearance of flow in the abnormal vessels. This remained unchanged in two patients, where as increased flow in the same vessels was demonstrated by further follow-up MR angiography studies in two patients. Phase contrast MR angiography is a useful complement to MR imaging in the post-treatment evaluation of spinal vascular malformations. An early post-treatment MR-angiography control is recommended as it enables prompt identification of treatment failures and may constitute a reference term for lesion monitoring over time.
Degenerazione ipertrofica delle olive inferiori Segnalazione di un caso
Authors: Lanza P.L. , Auteri W. , Armentano G.A. , De Vuono G. , Santoro G. 
Published: April 2015

Olivary hypertrophic Degeneration (OHD) is usually due to hemorrhagic lesions in the “Guillain Mollaret” triangle: trangular morphologic and functional relationship between the red nucleus and inferior olivary nucleus on one side and the controlateral dentate nucleus. The hemorrhage involves the pons-midbrain tegmentum on the same side of the olive or the controlateral superior cerebellar peduncle and/or dentate nucleus. It is regarded as transsynaptic degeneration and has typical MR features: morphologic changes and increased signal intensity on DP-T2 weighted images, with a carachteristic chronologic evolution after acute injury. We present a case report.
Analisi gestionale sull'indagine radiografica nei traumi cranici
Authors: Coppola V. , Brunese L. , Ranieri P. , Alfinito M. , Coppola M. , Maraziti G. , Noviello D. 
Published: April 2015

23415 x-ray examinations of the skull performed in an emergency department were examined retrospectively. The results show that it is wrong and dangerous, for medical-legal reasons, to perform x-ray examinations of the skull systematically in institutions where CT is available, as: – the uselessness of the examination, also for legal purposes, has been demonstrated; – its cost is twice the CT examination, on average; – the radiologist's and the technician's demotivation compromises the diagnostic effectiveness in every case; – the unmotivated use of CT and hospitalization becomes more frequent; – the execution time is wasted and not useable otherwise; – the deleterious sectorialization between abdominal and cerebral radiologists hampers the global and overall evaluation of the traumatised patient; – radioprotection reasons press for a more cautious use of radiation.
Magnetic Resonance Angiography for Evaluation of Intracranial Aneurysms Treated with Guglielmi Detachable Coils
Authors: Cotroneo E. , Dazzi M. , Gigli R. , Guidetti G. , Cantore G.P. , Chiappetta F. 
Published: April 2015

Thirteen cases of cerebral aneurysms submitted to endovascular treatment using Guglielmi detachable coils (GDC) are described. Control MRI-angiography 3D TOF was performed three and six months later. In order to spare patients the discomfort and risks related to repeated trauma and iodate contrast injection, we examined the possibility of an alternative non-invasive diagnostic method. For this purpose, the digital subtraction angiograms performed three and six months after embolisation were compared with the MR-angiograms obtained in the same period, all using the same tomograph at middle field intensity (0.5T). We discuss the outcome of this comparison and the limits of the MR-angiography method in the follow-up of aneurysms submitted to endovascular treatment.
Orbital Pseudotumour: Clinical and Radiological Assessment
Authors: Roncallo F. , Bandini F. , Mazzella L. , Giberti L. , Turtulici I. , Bartolini A 
Published: April 2015

Orbital Pseudotumour (OP) is an antiquated term that denotes an idiopathic and nonspecific space-occuping inflammation of any of the orbital structures. The clinical presentation can be acute, subacute or chronic and depends on the structures involved. Aim of the study is to evaluate the different anatomic variants of OP, with emphasis on the differential diagnosis with other pathologies, especially malignancies. We report a retrospective comparison of the clinical, CT and MR findings of 50 patients with non-traumatic orbital pathology, diagnosed between 1993 and 1996. We stratified the radiologic examinations on the basis of the main anatomic structure involved: Lacrimal gland (8 cases); Extrinsic ocular muscle(s) (14 cases); Optic nerve-optic nerve sheaths complex (12 cases); Superior ophthalmic vein (7 cases); Orbital apex (5 cases); Retrobulbar soft tissues (3 cases). We found no specific clinical signs or pathognomonic CT or MR findings to establish a certain diagnosis, although contrast enhancement was present in 100% of the cases and could thus be considered a distinguishing feature. We also found a good correlation between the location and the extent of the disease as identified on CT and MR scans with the clinical presentation. With regard to differential diagnosis we found: Lacrimal gland: PO (4), Lymphoma (2), Septic dacryoadenitis (2); Extrinsic ocular muscle(s): PO (7), Thyroid ophthalmopathy (5), Metastasis (2); Optic nerve-optic nerve sheaths complex: PO (4), Autoimmune diseases (4), meningioma (2), Lymphoma (1), Glioma (1); Superior ophthalmic vein: PO (1), Carotid-cavernous fistula (3), orbital varyx (3); Orbital Apex: PO (2), Metastasis (2), Meningioma (1); Retrobulbar soft tissues: PO (1), Lymphoma (1), Septic cellulitis (1). OP represents a frequent cause of orbital pathology in the adult. The differential diagnosis with other entities is not always simply on the basis of morphologic pattern and the biopsy may also be inconclusive, especially in distinguishing between OP and lymphoma. All but one patients improved clinically following administration of corticosteroids and the abnormalities on the CT and MR scans disappeared or became less prominent within 45 days after starting the steroid treatment. The radiologic recognition of this particular disease is important since the response to steroid therapy is almost always dramatic and the prognosis for complete recovery is relatively good. Biopsy is reserved only to steroid non-responder patients.
Sindrome da ipotensione liquorale secondaria a rachicentesi in un paziente con AIDS linfoma non Hodgkin
Authors: Crispino M. , Prandini F. , Gregis G.P. , Oladeji O.A. , Nasta P. , Pavia M. , Bonetti M. , Gasparotti R. 
Published: April 2015

Viene descritto il caso di un paziente affetto da AIDS e Linfoma non Hodgkin con sindrome da ipotensione liquorale secondaria a ripetute punture lombari. La TC e la RM mostravano una duplice raccolta sottodurale a contenuto liquorale, con impregnazione della pachimeninge, associata ad effetto compressivo sull'encefalo e dislocazione verso il basso del tronco encefalico. Il quadro clinico si risolveva spontaneamente in circa due settimane, così come confermato dai reperti neuroradiologici.
Compressive Vertebral Angioma
Authors: Izzo R. , Muto M. , Fucci G. , Cantatore G. , Simpatico S. , Avella F. 
Published: April 2015

We describe a case of compressive vertebral angioma characterized by unexpected onset and the rapid development of signs of spinal medulla compression not preceded by painful symptomatology. Haemangioma is the most common benign tumour in the spine. In the vast majority of cases it is a small, clearly located and circumscribed vascular dysplasia which is stable over time, asymptomatic and is detected by chance via radiological control. In rare cases vertebral angioma with tumoral behaviour can have an extensive effect on the vertebral body and arch and invade the spinal canal causing myeloradicular compression. This type of angioma, defined as compressive, is a developing lesion which necessitates full radiological assessment and decompression therapy, to be carried out in certain cases and in our case, as part of an emergency regimen. Between the two extreme forms of angioma, compressive and asymptomatic, there are the painful or symptomatic forms classified as both compressive in the transitional phase and as lesions of intermediate aggressiveness which are not destined to develop further.
18FDG-SPECT Imaging of Brain Tumours
Authors: Reiche W. , Schaefer A. , Schmidt S. , Moringlane J. R. , Feiden W , Kirsch C. M. , Piepgras U. 
Published: April 2015

The purpose of this prospective study was to examine, if it is possible in principal to obtain suitable information to grade brain tumours and detect recurrences in follow up with 18Fluoro-Deoxyglucose (18FDG) and Single Photon Emission Computed Tomography (SPECT) using ultra high energy collimators. Fifty two brain SPECT investigations were carried out in 41 patients. Forty patients had primary brain tumours and one an anaplastic meningioma. SPECT acquisition was started 30 min after application of 400 MBq 18FDG using special high energy 511 KeV collimators. After attenuation correction (coef.= 0.07 cm−1/) brain tumour FDG uptake was quantified as ratio to contralateral brain cortex (RUV: relative uptake value). SPECT data were compared with histopathological findings and CT/MR images. In grade 4 gliomas (glioblastomas), 18FDG uptake depended on the ratio viable tumour tissue, taking up contrast media in CT/MRI, to cystic tumour areas. Two cases showed increased uptake (RUV = 1.33 and 1.05) compared to the contralateral cortex and four with central necrosis a decreased uptake (RUV = 0.79 ± 0.14). Grade 2 gliomas (five cases) showed a decreased 18FDG uptake (RUV = 0.68 ± 0.02) compared with contralateral brain cortex. In grade 3 astrocytomas (two cases), 18FDG uptake was significantly lower than cortex uptake, but slightly increased when compared with white matter uptake (RUV = 0.79 and 0.82). In follow-up, eight patients with a grade 4 glioma recurrence and one patient with a medulloblastoma recurrence showed an increased 18FDG uptake (RUV = 1.2 ±0.09 and 1.2). In one grade 4 glioma recurrence, SPECT results were false negative showing decreased FDG-uptake due to the presence of necrotic areas induced by radiotherapy. Grade 2 glioma recurrences (eight cases) showed low 18FDG uptake values (RUV = 0.73 ± 0.11). Radionecrosis also showed a decreased 18FDG uptake (RUV = 0.64 ± 0.09) compared with unaffected cortex. These results demonstrate that grading and follow-up tests of brain tumours are possible with 18FDG-SPECT, although SPECT with high energy collimators provides a relatively poor spatial resolution which requires further technical improvements.
Colloid Cyst
Authors: Duca S. , Salzedo E. 
Published: April 2015

Colloid cysts are rare benign intracranial tumors most commonly found in the third ventricle, but also in the subarachnoid spaces and within the brain parenchyma. Many names have been proposed depending on their location, such as neuroependymal cyst, ependymal cyst, glioependymal cyst, choroid plexus cyst and epithelial cyst. From the neuroradiological point of view two forms have been described: a “solid” form with a compact round mass that is iso-hyperdense in CT and slightly hyperintense in T1W and highly hypointense in T2W MR images, and a “cystic-solid” form, characterised by a peripheral fluid collection surrounding a solid central core. This report describes the modifications of a solid form in a cystic-solid cyst, not previously described in the literature, and its evolution after neurosurgical drainage of the fluid collection. Some pathogenetic hypotheses on intracystic fluid production are discussed and displacement of the central solid core inside the cyst is shown.
Optic Nerve and Chiasma Compression by a Dolichoectatic Internal Carotid Artery
Authors: Blandino A. , Longo M. , Salpietro F.M. , Alafaci C. , Narbone C. , Bramanti P. , Pandolfo I. 
Published: April 2015

We describe an unusual type of neurovascular conflict between an elongated internal carotid artery and the optic nerve-chiasma complex. The fundamental role of conventional MR and MR angiography in the demonstration of the neurovascular conflict is illustrated.