Musculoskeletal MRI at 7 T: do we need more or is it more than enough?

Ultra-high field magnetic resonance imaging (UHF-MRI) provides important diagnostic improvements in musculoskeletal imaging. The higher signal-to-noise ratio leads to higher spatial and temporal resolution which results in improved anatomic detail and higher diagnostic confidence. Several methods, such as T2, T2*, T1rho mapping, delayed gadolinium-enhanced, diffusion, chemical exchange saturation transfer, and magnetisation transfer techniques, permit a better tissue characterisation. Furthermore, UHF-MRI enables in vivo measurements by low-γ nuclei (23Na, 31P, 13C, and 39K) and the evaluation of different tissue metabolic pathways. European Union and Food and Drug Administration approvals for clinical imaging at UHF have been the first step towards a more routinely use of this technology, but some drawbacks are still present limiting its widespread clinical application. This review aims to provide a clinically oriented overview about the application of UHF-MRI in the different anatomical districts and tissues of musculoskeletal system and its pros and cons. Further studies are needed to consolidate the added value of the use of UHF-MRI in the routine clinical practice and promising efforts in technology development are already in progress

Humeral greater tuberosity osteolysis as a complication of intraosseous calcification migration: Natural history depicted by imaging

Migration of calcification within the bone leading to greater tuberosity osteolysis is a peculiar complication of the calcifying tendinitis of the rotator cuff. The case of a 38-year-old woman complaining of right shoulder pain, which had been going on for one year, is hereby described. The evolution of the infraspinatus tendon calcifying tendinitis leading to osteolysis of the greater tuberosity of the humerus is depicted by imaging and, particularly, by the MR and CT features changing over time. In this paper we focus on the importance of both MR and CT exams in the diagnostic process of the different phases of the disease. The correlation between clinical symptoms and imaging features is also helpful for imaging interpretation: the most painful phase corresponds to the migration of the calcification, whereas pain tends to decrease when the osteolysis develops. Awareness of the existence of this condition may prevent unnecessary invasive procedures. (www.actabiomedica.it)

A new physeteroid cetacean from the Lower Miocene of southern Italy: CT imaging, retrodeformation, systematics and palaeobiology of a sperm whale from the Pietra leccese

Herein we describe a new finding of a medium-sized sperm whale from the Burdigalian (Lower Miocene) of the Pietra leccese formation (southern Italy) on the basis of a partly prepared specimen that includes a partial cranium, seven detached teeth, the fragmentary right mandible and two partial vertebral bodies. Because of the overall compression of the specimen, we carried out a retro deformation of a 3D model of the cranium obtained via CT-scanning. The combined analysis of the original specimen and the retrodeformed model has allowed us to recognise that the studied specimen constitutes a new physeteroid taxon: Angelocetus cursiensis n. gen. n. sp., a longirostrine sperm whale characterised by a sideward projected supracranial basin, as evidenced by the overall displacement of its posteriormost margin. Based on a phylogenetic analysis, A. cursiensis n. gen. n. sp. is determined to be a crown physeteroid that does not belong to either the Physeteridae or the Kogiidae. The wide temporal fossa, elongated rostrum and slender teeth, as well as the skull dimensions (estimated bizygomatic width c. 550 mm) suggest a diet based on medium to large-sized bony fish that were likely captured by a raptorial pierce feeding strategy (as for most of the coeval Burdigalian physeteroids). Despite a seemingly low ecomorphological disparity, the high degree of taxonomic diversity of the Burdigalian physeteroids suggests that this time span represents a crucial phase for the evolutionary history of sperm whales

Basic knowledge and new advances in panoramic radiography imaging techniques: A narrative review on what dentists and radiologists should know

Objectives: A panoramic radiograph (PAN) is the most frequently diagnostic imaging technique carried out in dentistry and oral surgery. The correct performance of image acquisition is crucial to obtain adequate image quality. The aim of the present study is to (i) review the principles of PAN image acquisition and (ii) describe positioning errors and artefacts that may affect PAN image quality. Methods: Articles regarding PAN acquisition principles, patient’s positioning errors, artefacts, and image quality were retrieved from the literature. Results: Head orientation is of the utmost importance in guaranteeing correct image acquisition. Symmetry, occlusal plane inclination, mandibular condyles localization, cervical spine position, aspect of upper teeth root apexes, exposure parameters, and metal and motion artefacts are factors that greatly affect the image quality of a successful PAN. Conclusions: Several factors are the basis for PAN performance; therefore, a systematic approach that takes into account correct patient positioning and preparation is strongly suggested to improve overall examination quality

Hydronephrosis and pyonephrosis

Urinary tract infections (UTIs) are a frequent clinical problem in infants and children, and they may develop into serious complications with long-term sequelae. Their prevalence varies according to age and sex: males are more interested in the neonatal period and in the first year of age, while females are more involved after that time. The clinical outcome and the severity of UTIs depend on many risk factors including urinary tract malformations and dysfunctions, virulence and properties of the pathogen, host response to the infection, and promptness of diagnosis and management

Ambulance location through optimization and simulation : the case of Milano urban area

In this paper, the problem of locating ambulance posts over an urban area is considered. A three steps approach is presented to deal with this problem, that combines different skills. First, the real life data on the considered system behavior are analyzed. Then, integer linear programming models are considered with the aim of finding new post locations. As such models represent a simplification and an abstraction with respect to the real life situation, the behavior of the proposed solutions is tested with a simulation framework, tailored on the considered problem features. The whole approach is tested over the Milano city area case, with the aim of pointing out the criticality of the system and providing suggestions for the emergency service management. Computational results are presented and discussed

Ultra-High Frequency Ultrasound (Uhfus) Applications in Sjogren Syndrome: Narrative Review and Current Concepts

Primary Sjogren’s syndrome (SS) is a systemic autoimmune chronic inflammatory disease with predominant involvement of the exocrine glands, particularly the salivary glands (SGs). The role of salivary glands ultrasound (SGUS) in the work-up of patients with primary Sjogren syndrome (SS) is progressively increasing due to its useful support in diagnosis and follow-up as a widely available, repeatable, noninvasive and safe technique. Although SGUS is not yet included in the dominant primary SS classification, several studies supported its inclusion in the American College of Rheumatology/European League Against Rheumatism criteria. In this context, a novel imaging technique, ultra-high frequency ultrasound (UHFUS), is being explored. Compared to the frequencies used in conventional ultrasound (US) (up to 22 MHz), UHFUS operates with higher frequencies (30–100 MHz) allowing for outstanding image resolution, up to 30 μm. UHFUS permits the scn of both major and minor SGs, opening new avenues for the integration of tissue and imaging biomarkers. Although further studies are needed to confirm its role, this novel imaging technique might lead to several potential improvements, including earlier diagnosis, reduction of unnecessary and inadequate biopsies and better management and follow-up of patients with primary SS

Soil properties relevant to land degradation in abandoned sloping fields in Aisa valley, Central Pyrenees (Spain)

A multi-approach characterization of soil properties in abandoned fields in the Aisa valley, at mid mountain in the Central Spanish Pyrenees, demonstrated that the soil's own peculiar characteristics are concerned with conservation problems. Aggregate stability and shrinkage tests pointed to a relatively good soil performance due to the aggregating role of organic matter and calcium carbonates, although calcium ions, in some instances, may exert and additional antagonistic role for a sealed surface, increasing runoff. On the other hand, soil micromorphology suggests that the poor condition of the soils is in some contradiction to paedogenic activity. These findings, together with the presence of ashes, support the hypothesis that land degradation in these areas is mainly related to human activity thought unsuitable management after land abandonment.[es] La caracterización de diversas propiedades del suelo en campos abandonados del valle de Aisa, montaña media del Pirineo Central, ha mostrado que dichos suelos presentan algunos caracteres de interés desde el punto de vista de la conservación. La estabilidad de los agregados y los test de agrietamiento evidencian un comportamiento aceptable, gracias al papel agregante de la materia orgánica y carbonatos de calcio, a pesar que los iones calcio, en algunas ocasiones, pueden ejercer un papel antagonista adicional y favorecer el sellado de la superficie del suelo, aumentando la escorrentía superficial. Por otra parte, la micromorfología sugiere que el estado de degradación de los suelos contrasta con la actividad pedogénica. Estos resultados, juntamente con la presencia de cenizas, apoyan la hipótesis de que el estado de degradación en estas áreas es consecuencia principalmente de una utilización incorrecta después del abandono de los cultivos. [fr] Un étude des propriétés des sois dans une zone à cultures en pente abandonnées dans la vallée d'Aisa (Pyrénées Centrales) nous a montré quelques caractéristiques significatives du point de vue de leur conservation. En effet, les essais de stabilité des agrégats et les essais de rétraction montrent un comportement satisfaisant qui peut être attribué au rôle de la matière organique et au ion calcium, malgré qui celui peut favoriser le scellage de la surface. La micromorphologie des sols suggère que la pauvreté de ces sols est en contradiction avec l'activité pédogénique. Ces résultats et la présence de cendres dans le profil appuyant l'hypothèse que le mauvais état de conservation de ces aires peut être principalement attribuée aux pratiques souffertes après leur abandonnement