bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocollo diagnostico non invasivo nelle stenosi carotidee
Authors: Turtulici I. , Roncallo F. , Giberti L. , Bartolini A. 
Published: April 2015

Digital Subtraction Angiography (DSA) is now considered the elective diagnostic tool in the evaluation of carotid artery steno-occlusive pathology, although the use of intra-artery catheters implies some iatrogenic risk. Aim of the study is to evaluate the possible utilization of a flow-chart based on non-invasive diagnostic tools, such as Ultrasound (US) and Angio-CT in the pathology of neck vessels. We retrospectively evaluated 35 pts with previous Transient Ischaemic Attacks (TIAs) in the carotid artery territory, aged between 38 and 67 years; 21 males, 14 females. The NASCET classification was used to quantify the entity of each carotid stenosis. All patients underwent neck US and Angio-CT; in 15 of them Angio-MRI and DSA were also performed. Angio-CT protocol implies volumetric acquisition from the C6 to the suprasellar region, 3 mm thick slices, 1.5 pitch, 100 ml TV c.m., 3 ml/20 s acquisition time, 1 mm axial image reconstruction, elaboration techniques: SSD, MIP. US and Angio-CT images were comparated with Angio-MRI and DSA findings; according to the present study, axial, SSD, MIP Angio-CT images have the same accuracy as DSA in the evaluation of vessel course and stenosis degree; in the evaluation of the vessel course only they are comparable to Angio-MRI; in the quantification of the stenosis their reliability is the same as US. Angio-CT is more sensitive than DSA and MRI in the evaluation of parietal abnormalities. The complementary use of US and Angio-CT techniques gives functional and anatomical information about extra-and intracranial carotid course, making invesigation possible also in uncooperative patients with minimal invasivity.
Trattamento percutaneo delle stenosi dei tronchi sovra-aortici: Esperienza multicentrica in Campania
Authors: Briganti F. , La Tessa G. , Cirillo S. , Sirabella G. , Saponiero R. , Napoli A.N. , Simonetti L. , Maglione F. , Tecame S. , Elefante R. 
Published: April 2015

Nell'ambito della patologia stenotica dei vasi epiaortici la P.T.A. ha raggiunto un ruolo di primo piano; essa rappresenta il trattamento di prima scelta nelle stenosi delle origini delle arterie carotidi e succlavie. L'introduzione di protesi endovascolari (stent) ha migliorato i risultati del trattamento endovascolare. Questo lavoro valuta i risultati ottenuti da un gruppo di studio campano in tre differenti centri di neuroradiologia interventistica in quattro anni di attività sono stati trattati 35 pazienti affetti da patologia steno-ostruttiva del distretto epiaortico con un'età compresa tra i 60 ed i 72 anni. La valutazione dei risultati pertanto è stata fatta sul controllo angiografico immediato e clinico-strumentale (echo-doppler) a distanza.
Angiografia RM a contrasto di fase delle fistole arterovenose durali intracraniche
Authors: Cellerini M. , Mascalchi M. , Ferrito G. , Mangiafico S. , Scazzeri F. , Olmastroni M. , Marin E. , Scardigli V. , Dal Pozzo G. , Quilici N. 
Published: April 2015

Ten patients with native intracranial dural arteriovenous fistulae (DAVF) demonstrated by arteriography underwent MR imaging and phase contrast MR angiography before treatment. The DAVFs were of type I (n=2), IIa (n=l), II a+b (n? 3), and TV (n=4). Joint review of the arteriography, MR imaging and MR angiography hard copies was performed by two observers. MR imaging showed intracerebral hemorrhage in 2 patients and diffuse or focal white matter edema in 2. Focal venous ectasias in 4 patients with type TV DAVF and dilated cortical vessels in 6 patients were recognized on MR images. MR angiography enabled identification of the DAVF nidus in 2 patients, hypertrophic feeding vessels in 5 patients and cortical dilated veins in 8 patients. Steno-occlusive alterations of the dural venous sinuses in 6 patients were readily demonstrated on MR angiography. Moreover, in 3 patients with type II a+b DAVFs, reconstruction of image phase of MR angiography allowed identification of flow revers al in the dural sinuses near the DAVF. Phase contrast MR angiography is a useful complement to MR imaging for identification and characterization of intracranial DAVF.
L'esame Spect nella patologia del SNC in età pediatrica: Esperienze preliminari
Authors: Ruggiero R. , Covelli E. , Carannante G. , Buonocore M.C. , Leone E. 
Published: April 2015

I recenti progressi nella tecnologia Spect hanno prodotto un evidente aumento della sensibilità e della risoluzione dei sistemi di acquisizione ed elaborazione consentendo una estensione della applicazione della metodica a svariate patologie, particolarmente a quelle di pertinenza neurologica. In età pediatrica la Spect ha, negli ultimi anni, fornito ulteriori informazioni nello studio delle epilessie. Noi abbiamo iniziato da alcuni mesi ad applicare la metodica nello studio di patologie del SNC della prima età pediatrica. In questo lavoro vengono presentati i risultati preliminari e viene posta una iniziale verifica se i dati Spect, correlati con gli altri dati strumentali, possano essere utili nell'iter diagnostico di queste patologie.
Valutazione dello spettro di alterazioni ischemiche cerebrali in pazienti asintomatici affetti da talassemia e talasso-drepanocitosi: Valore della RM nel protocollo terapeutico
Authors: Manfrè L. , Accardi M. , Vaccaro G. , Raineri R. , Giarratano E. , Lagalla R. 
Published: April 2015

La patologia ischemica rappresenta la causa principale di lesione cerebrale nei pazienti affetti da drepanocitosi, ed è stata documentata mediante RM nei pazienti affetti da stroke. Alterazioni ischemiche possono tuttavia avere luogo anche in assenza di una obbiettività clinica. Recentemente è stato dimostrato il ruolo della RM nella valutazione delle ischemie cerebrali in pazienti affetti da talasso-drepanocitosi e da talassemia. Scopo del lavoro è stato quello di analizzare le alterazioni presenti in una coorte di pazienti affetti da tali alterazioni. 20 pazienti al di sotto di 50 anni di età, affetti da talasso-drepanocitosi (età media 29.5) e 20 affetti da talassemia (età media 31.7), previo consenso informato, sono stati sottoposti ad una valutazione T1- e T2-ponderata a livello encefalico, mediante apparecchiatura operante a medio campo e bobina in quadratura. Due centri di ricerca per la talassemia sono stati coinvolti (Palermo, Caltanissetta), selezionando unicamente i pazienti con anamnesi negativa per pregressa sindrome neurologica acuta. Le lesioni ischemiche sono state valutate soggettivamente e classificate in piccole (<0.5 cm), medie (0.5 − 1.5 cm) e ampie (>1.5 cm) ed in singole o multiple. Il 30% (6/20) dei pazienti affetti da talasso-drepanocitosi presentava multiple lesioni ischemiche con una prevalenza di lesioni medie o grandi 5/20 (25%). In un paziente veniva dimostrata la presenza di multiple malformazioni artero-venose leptomeningee, confermate al bilancio angiografico. Il 20% (4/20) dei pazienti affetti da talassemia presentava lesioni ischemiche piccole, singole in 2 casi (50%). Il trattamento trasfusionale, per quanto non scevro di rischi, viene proposto oggi nei pazienti affetti da drepanocitosi colpiti da episodio ischemico cerebrale. Il trattamento dei pazienti asintomatici affetti da talasso-drepanocitosi non è al momento codificato: una valutazione sequenziale mediante RM potrebbe identificare i pazienti “a rischio” per incidenti vascolari, indirizzandoli alla terapia adeguata (idrossiurea, trapianto di midollo, trasfusione).
Spontaneous Intracranial Hypotension and MRI
Authors: Muras I. , Scuotto A. , Maisto M. , Bernini F.P. 
Published: April 2015

Postural headache due to low intracranial pressure is a well-known entity and is most commonly encountered following lumbar puncture. It may occur as a consequence of a medical condition (dehydratation, uremia, etc.) but in some cases no precipitating event is apparent and the intracranial hypotension is believed to have developed spontaneously. In such cases the underlying cause of the syndrome is rarely established and treatment is non specific. We describe three patients with spontaneous intracranial hypotension examined with MRI of the brain. Women are more commonly affected than men in the third or fourth decades of life. Schaltenbrand (1938) proposed three mechanisms by which spontaneous intracranial hypotension may be explained: diminished CSF production; CSF hyperabsorption, CSF leakage. The defect causing a CSF leak usually remains obscure. Several cases of diffuse meningeal enhancement on MRI have recently been described, probably due to meningeal hyperaemia resulting from the low CSF pressure. Subdural fluid collections have also been detected as a result of rupture of bridging veins due to the decrease in CSF volume and downward displacement of the brain. In our cases, MRI showed a diffuse dural thickening, hyperintense in T2. Spontaneous intracranial hypotension is often a self-limiting disease, responding well to bed rest and a generous intake of oral or parenteral fluid and salt.
Magnetic Resonance Angiography in a Case of Agenesis of the Left Carotid Artery Associated with Transellar Intercarotid Anastomosis
Authors: Gozzoli L. , Crasto S. , Leombruni S. , Bradac G.B. 
Published: April 2015

Congenital absence or hypoplasia of the internal carotid artery is an extremely rare developmental abnormality. Usually these patients are asymptomatic because of functional compensation via the circle of Willis. A less frequent collateral circulation can occur by way of the primitive maxillary artery, an embrionic vessel originating from the controlateral carotid siphon and running through the sella turcica. We describe a fortuitous finding of unilateral agenesis of the internal carotid artery with intercavernous anastomosis in a patient with a meningioma adhering to the lateral margin of the right anterior clinoid. The case was studied by CT, MRI, MR angiography and digital subtraction angiography
Clinical and Radiological Patterns of Human Stroke as Defined by Echo-Planar Diffusion-Weighted MR Imaging
Authors: Lövblad K.O. , Weber J. , Heid O. , Mattle H.P. , Schroth G. 
Published: April 2015

We sought to establish the validity of echo-planar diffusion-weighted imaging (DWI) in acute stroke using anisotropic and isotropic imaging. 32 patients with a clinical suspicion of stroke were examined by echo-planar DWI on a 1.5 T magnet. The earliest imaging was performed 90 minutes after onset of symptoms, up to 47 hours. In 30 cases an area of hyperintensity was detected in the brain with a corresponding drop in the rADC. The ADC drop varied between 10 and 55% when compared to non-ischemic tissue. In two cases where no lesion was detected, symptoms did disappeared and TIAs were diagnosed. Diffusion-weighted imaging of the brain is feasible in patients with acute stroke and appears to be sensitive to the acute cerebral changes encountered in ischemia. I should therefore be possible to use it to select patients for further intervention.
CTA and DSA Evaluation of Patients with Subarachnoid Haemorrhage
Authors: Muto M. , Bonsignore R. , Ambrosanio G. , Esposito G. , Cesaro L. , Di Furia U. , Palmieri A. 
Published: April 2015

We correlate digital subtraction angiography (DSA) and computed tomography with angiographic 3D reconstruction (CTA) in patients with subarachnoid haemorrhage. 45 patients were evaluated with both techniques (CTA and DSA) within 3–4 days after acute haemorrhage: source CT images, MIP and 4D-angio reconstruction and standard DSA were performed and correlated. The MIP tecnique is very easy and quick to perform and operator independent, while 4D-angio reconstruction requires at least 30 minutes to obtain good quality images. CTA and DSA were equivalent in demonstrating the presence of all 57 aneurysms in the 45 patients. Most aneurysms were located at the level of the circle of Willis; CTA was not adequate to demonstrate the neck of aneurysms in 7 cases located in of the syphon, vertebral artery and posterior communicating artery; CTA gave a good display of the thrombus within the aneurysm. Patients could go directly from the CT diagnostic room to the operating room in certain types of aneurysm such as those in the anterior communicating artery or middle cerebral artery in which there is a correlation between site of the haemorrhage and the aneurysm. In the future, improvements in MR technology will also exclude aneurysms in sites difficult to evaluate by CTA such as the syphon, so that DSA will be performed only in selected doubtful cases.
Controllo neuroradiologico precoce su una casistica di 132 tumori encefalici operati
Authors: Bacci A. , Barbara C. , Simonetti L. , Bartolini S. , Belveder C. , Leonardi M. 
Published: April 2015

Vengono riportati i risultati di uno studio su un campione costituito da 132 tumori intracerebrali primitivi operati dal 1 gennaio 1996 al 31 dicembre 1996 presso la Divisione di Neurochirurgia dell'Ospedale Bellaria di Bologna. I tumori erano per la maggior parte gliomi ad alto grado di malignità, poi gliomi a basso grado, gangliocitomi, ependimomi, medulloblastomi. In tutti i casi è stato eseguito un esame neuroradiologico postoperatorio precoce TC o RM prima e dopo somministrazione di mdc. In accordo con i dati riportati in letteratura il controllo postoperatorio è stato effettuato entro il terzo o quarto giorno dall'intervento, affinchè le modificazioni parenchimali conseguenti all'atto chirurgico non rendessero difficoltosa o impossibile la rilevazione della presenza o assenza di residuo neoplastico. È stato scelto di fare lo studio TC nei tumori maligni e lo studio RM nei gliomi a basso grado di malignità o tumori della fossa cranica posteriore. Nei 98 casi in cui la rimozione chirurgica era stata parziale o subtotale anche gli esami neuroradiologici mostravano la presenza di residuo neoplastico. Dei 34 casi in cui il giudizio neurochirurgico era stato di asportazione totale della neoplasia, in 14 era possibile stabilire la presenza di residuo tumorale certo, in 4 dubbio, in 9 non-residuo e in 7, per la presenza di ematoma nel cratere, non era possibile fare una valutazione certa. La necessità di documentare la presenza o meno di residuo neoplastico dopo l'intervento chirurgico nasce da esigenze prognostiche e di pianificazione terapeutica. È stato documentato che la prognosi peggiora drammaticamente in presenza di residuo. Infatti il 75% dei pazienti con glioma maligno, se ha residuo nel controllo postoperatorio, presenta la ripresa della malattia entro 6 mesi, cosa che si verifica solo nel 36% dei pazienti senza residuo. Nella pianificazione della terapia postchirurgica: radioterapia o chemioterapia, la presenza o meno di residuo neoplastico è di fondamentale importanza. Nei tumori maligni in presenza di residuo si può ipotizzare, dopo la radioterapia convenzionale, l'esecuzione di “Boost” focalizzato con radiochirurgia o brachiterapia. Inoltre attualmente si tende ad effettuare chemioterapia solo in caso di presenza di residuo tumorale postoperatorio. Nei tumori a basso grado di malignità la radicalità della chirurgia riveste ancora maggiore importanza. Infatti nei pazienti giovani, al di sotto dei 30 anni di età, se il tumore è stato asportato completamente la radioterapia può essere rimandata fino al momento dell'eventuale ripresa di malattia.
Tuber Cinereum Hamartomas and Gelastic Epilepsy
Authors: Cirillo S. , Caranci F. , Briganti F. , D'Amico A. , Striano S. , Elefante R. 
Published: April 2015

We studied five patients with gelastic epilepsy sustained by hamartoma of the tuber cinereum, submitted to EEG and Video-EEG study and to MR examination. The mechanism of ictal laughter, clinical associations and prognosis for seizure control are discussed. Hamartomas should be always suspected when gelastic seizures occur, and appropriate diagnostic tools should be employed for their diagnosis. In patients presenting with gelastic epilepsy, MR assessment of the hypothalamic region is necessary to identify a hamartoma of the tuber cinereum. Moreover, the resolution of MR imaging provides a basis to correlate some of the clinical manifestations with the anatomical disposition of the lesion within the hypothalamus. Gelastic epilepsy seems to correlate with large broad-based hamartomas in relationship with the mamillary bodies. In these cases, surgical treatment should be considered when symptoms are not sufficiently responsive to medical therapy.
Pathogenesis of Chiari Malformation: A Morphometric Study of the Posterior Cranial Fossa
Authors: Nishikawa M. , Sakamoto H. , Hakuba A. , Nakanishi N. , Inoue Y. 
Published: April 2015

To investigate overcrowding in the posterior cranial fossa as the pathogenesis of adult type Chiari malformation, we morphometrically studied the brainstem and cerebellum within the posterior cranial fossa as well as the occipital bone while taking into consideration their embryological development. Compared with the control group, the Chiari group had a significantly larger “volume ratio” as PFBV/PFCV, the three occipital enchondral parts (the basiocciput, exocciput and supraocciput) were significantly smaller and the tentorium was much steeper. There was no significant difference in the posterior fossa brain volume or in the axial lengths of the hindbrain (the brainstem and cerebellum). These results suggest that in adult type Chiari malformation an underdeveloped occipital bone, possibly due to underdevelopment of the occipital somite originating from the paraxial mesoderm, induces overcrowding in the posterior cranial fossa which contains the normally developed hindbrain, and secondary the cerebellar tonsils herniate into the spinal canal.
Association of Lumbar Synovial Cysts with Facet Effusion
Authors: Schellinger D. , Fertikh D. , Henderson F. , Lauerman W.C. , Davis B. 
Published: April 2015

To show the frequent association of synovial cysts and facet effusion. MR studies of 26 patients with lumbar synovial cysts were reviewed for sex/age incidence, anatomic location, multiplicity of cysts and associated pathologies. All studies were reviewed for presence of facet effusion. 26 patients had 39 MRI documented synovial (17 females, 9 males). Age distribution: 41 – 79 years. Location of cysts: L4/5 = 29, L3/4 = 6, L5/S1 = 3, L1/2= −;1. 36 synovial cysts showed facet effusion. 19 patients also had facet effusions at adjoining motion segments or at contralateral joints. Synovial cysts were found in anterior (n=20), posterior (n=13), anterior-posterior (n=3) positions. 18 patients had cysts localized to one single facet joint, 8 patients showed synovial cysts at multiple facet joints. The frequent coexistence of synovial cysts and facet effusion in our material suggests a causal relationship. External herniation of synovium from a fluid expanded joint space appears to be the most plausible pathologic mechanism.
A single-center experience in radioembolization as salvage therapy of hepatic metastases of uveal melanoma
Authors: Schelhorn Juliane , Richly Heike , Ruhlmann Marcus , Lauenstein Thomas C , Theysohn Jens M 
Published: April 2015

Background Overall survival (OS) of patients with hepatic metastases of uveal melanoma is strongly linked with hepatic tumor control. Due to the lack of an effective systemic chemotherapy, locoregional therapies like radioembolization should play an increasingly important role. Purpose To report complications and response rates of radioembolization as salvage therapy for hepatic uveal melanoma metastases. Material and Methods Between October 2006 and January 2014, eight patients (age, 59.1 ± 15.3 years; 5 men) with histologically proven uveal melanoma and hepatic metastases received radioembolization with glass microspheres at a single center. All patients had been heavily pretreated with multiple systemic/locoregional therapies resulting in a long median interval between diagnosis of hepatic metastases and radioembolization (17.1 months; range, 6.4–23.2 months). Follow-up consisted of clinical assessment, laboratory tests and tri-phasic computed tomography (CT) before and 1, 3, 6, 9, and 12 months after radioembolization. Response to therapy was evaluated by CT using RECIST version 1.1 and by survival time. Safety (laboratory and clinical toxicity) was rated according to Common Terminology Criteria for Adverse Events 4.03. Using Kaplan-Meier analysis time to progression of hepatic metastases (hTTP) and OS were calculated. Results One month after radioembolization 50% of patients presented with stable and 50% with progressive disease. Median hTTP and OS after radioembolization were 4.3 weeks (range, 3.4–28.6 weeks) and 12.3 weeks (range, 3.7–62.6 weeks), respectively. Median OS after diagnosis of hepatic metastases was 19.9 months (range, 7.3–31.4 months). Radioembolization was tolerated well in all patients without toxicity higher than grade 2. Conclusion Radioembolization is a safe salvage therapy even in heavily pretreated hepatic metastases of uveal melanoma.
Emerging EPO and EPO receptor regulators and signal transducers
Authors: Kuhrt David , Wojchowski Don M. 
Published: April 2015

AbstractAs essential mediators of red cell production, erythropoietin (EPO) and its cell surface receptor (EPO receptor [EPOR]) have been intensely studied. Early investigations defined basic mechanisms for hypoxia-inducible factor induction of EPO expression, and within erythroid progenitors EPOR engagement of canonical Janus kinase 2/signal transducer and activator of transcription 5 (JAK2/STAT5), rat sarcoma/mitogen-activated protein kinase/extracellular signal-regulated kinase (RAS/MEK/ERK), and phosphatidylinositol 3-kinase (PI3K) pathways. Contemporary genetic, bioinformatic, and proteomic approaches continue to uncover new clinically relevant modulators of EPO and EPOR expression, and EPO’s biological effects. This Spotlight review highlights such factors and their emerging roles during erythropoiesis and anemia.
A phase 1 study of the bispecific anti-CD30/CD16A antibody construct AFM13 in patients with relapsed or refractory Hodgkin lymphoma
Authors: Rothe Achim , Sasse Stephanie , Topp Max S. , Eichenauer Dennis A. , Hummel Horst , Reiners Katrin S. , Dietlein Markus , Kuhnert Georg , Kessler Joerg , Buerkle Carolin , Ravic Miroslav , Knackmuss Stefan , Marschner Jens-Peter , Pogge von Strandmann Elke , Borchmann Peter , Engert Andreas 
Published: April 2015

Key Points
The bispecific, tetravalent antibody AFM13 represents a new approach engaging natural killer cells via CD16A to fight CD30+ malignancies. AFM13 is well tolerated and active in Hodgkin lymphoma patients who received all standard therapies, including brentuximab vedotin.