Encefalopatia ipertensiva cronica (EIC): sensibilita\u300 delle sequenze GE-T2* a confronto con le SWI nell'identificazione dei micro-sanguinamenti

L'EIC e\u300 caratterizzata dalla presenza di lesioni parenchimali irreversibili, risultato di una lunga esposizione a regimi pressori patologici specie in pazienti che non seguono o non rispondono alle comuni terapie mediche. Si riscontrano quali reperti tipici multipli esiti gliotici, leucoaraiosi e multiple lesioni lacunari con predilezione per le localizzazioni profonde ai nuclei lenticolari, ai talami e al ponte. Piu\u300 raramente possono evidenziarsi minuti foci emorragici parenchimali, piu\u300 frequentemente localizzati nei gangli della base ma anche nel ponte e nel cervelletto, che in alcuni casi possono rappresentare la manifestazione principale della patologia: questi microsanguinamenti, visibili incostantemente in TC, sono classicamente ben individuabili in RM come aree di netta ipointensita\u300 di segnale in GRE (Gradient Recalled Echo) T2* pesate. Scopo del nostro lavoro e\u300 quello di presentare due casi in cui l'EIC si manifesta prevalentemente con un quadro micro-emorragico confrontando la sensibilita\u300 delle convenzionali sequenze GRE T2* pesate con sequenze sensibili al fenomeno della suscettivita\u300 magnetica (Susceptibility-Weighted Imaging, SWI) di piu\u300 recente introduzione nella routine diagnostica

Septate uterus: nosographic overview and endoscopic treatment

To comment on the prevalence, diagnosis, and treatment of the septate uterus, with special reference to hysteroscopic metroplasty and its effect on reproductive outcome, we searched publications in PubMed and Embase. Original articles, meta-analysis, reviews, and opinion articles were selected. The studies suggest that the prevalence of the septate uterus is increased in women with repeated pregnancy loss and infertility. Reliable diagnosis depends on accurate assessment of the uterine fundal contour and uterine cavity by means of magnetic resonance and three-dimensional ultrasound. Pertinent published data comparing pregnancy outcome before and after hysteroscopic metroplasty indicated a marked improvement after surgery. Magnetic resonance and three-dimensional ultrasound represent the gold standard for diagnosis of septate uterus. Hysteroscopic metroplasty with its simplicity, minimal postoperative sequelae, and improved reproductive outcome is the gold standard for treatment, not only in patients with recurrent pregnancy loss and premature labor but also in patients with infertility, especially if in vitro fertilization is being contemplated

Cumulative doses analysis in young trauma patients: a single-centre experience

Multidetector computed tomography (MDCT) represents the main source of radiation exposure in trauma patients. The radiation exposure of young patients is a matter of considerable medical concern due to possible long-term effects. Multiple MDCT studies have been observed in the young trauma population with an increase in radiation exposure. We have identified 249 young adult patients (178 men and 71 women; age range 14\u201340 years) who had received more than one MDCT study between June 2010 and June 2014. According to the International Commission on Radiological Protection publication, we have calculated the cumulative organ dose tissue-weighting factors by using CT-EXPO software\uae. We have observed a mean cumulative dose of about 27 mSv (range from 3 to 297 mSv). The distribution analysis is characterised by low effective dose, below 20 mSv, in the majority of the patients. However, in 29 patients, the effective dose was found to be higher than 20 mSv. Dose distribution for the various organs analysed (breasts, ovaries, testicles, heart and eye lenses) shows an intense peak for lower doses, but in some cases high doses were recorded. Even though cumulative doses may have long-term effects, which are still under debate, high doses are observed in this specific group of young patients

SINCONAPP: A Computerized learning tool for CBCT normal anatomy and variants of the nose and paranasal sinuses

1. Purpose To supply an useful learning tool aimed to interactively display on mobile devices normal anatomy and variants of the nose and paranasal sinuses as seen on CBCT images. 2. Methods and Materials Images Images of the nose and paranasal sinuses were derived by a study series acquired by a CBCT device. CBCT studies of the paranasal sinuses were acquired in patients referred for nasal obstruction or sinusitis with the following parameters: 90 kVp, 12.5 mA, 20 s rotation time, FOV 13 x 14.5 cm, 0.25 x 0.25 x 0.25 mm voxel size. Software The application has been developed for iOS based mobile devices through the platform XCode provided by Apple®, and it is developed using the Objective-C programming language. The application has been configured as Master-Detail. This configuration splits the mobile device display in two panels. The left panel displays a list of the interesting items, while the right panel shows the relative details. Touching an item from the menu on the left panel, the textual description is shown on the same side, while the panel on the right will show the relative image. The application allows interactively navigation through normal anatomy and variants of the nose and paranasal sinuses, as represented on CBCT images in axial, sagittal and coronal planes. Cross-reference images to localize the same anatomic structures on different section planes are available. The navigation is intuitive, with multiple shortcuts. Different labels have been proposed in accordance with the specific anatomic lessic of the district and current literature references. High image quality with a zooming tool are available. 4. Conclusion An App for IOs devices was developed, that can represent an useful educational tool for medical students, residents and continuous medical education in radiology and other medical specialties dealing with nose and paranasal sinuses. This interactive atlas based on CBCT images could be also an useful option to be implemented on CBCT software

ROLE OF IMAGING IN THE PREOPERATIVE ASSESSMENT OF PELVIC AND EXTRAPELVIC ENDOMETRIOSIS: A PICTORIAL ESSAY

-To create a MR radiological template for endometriosis -To review MR reports and images in patients with endometriosis to assess the accurancy of the reports

SEMI-AUTOMATIC VOLUMETRIC SEGMENTATION OF THE UPPER AIRWAYS IN PATIENTS WITH PIERRE ROBIN SEQUENCE

Pierre Robin malformation is a rare craniofacial dysmorphism whose pathogenesis is multifactorial. Although there is some agreement in non-invasive treatment in less severe cases, the dispute is still open on cases with severe respiratory impairment. We present a semi-automatic novel diagnostic tool for calculating upper airway volume, in order to eventually address surgery in patients with Pierre Robin Sequence (PRS). Multidetector CT datasets of two patients and two controls were tested to assess the proposed method for ROI segmentation, upper airway volume computation and three-dimensional reconstructions. The experimental results show an irregular pattern and a severely reduced cross-sectional area (CSA) with a mean value of 8.3808 mm(2) in patients with PRS and a mean CSA value of 33.7692 mm(2) in controls (a ΔCSA of about -75%). Moreover, the similarity indexes and sensitivity/specificity values obtained showed a good segmentation performance. In particular, mean values of Jaccard and Dice similarity indexes were 91.69% and 94.07%, respectively, while the mean values of specificity and sensitivity were 96.69% and 98.03%, respectively. The proposed tool represents an easy way to perform a quantitative analysis of airway volume and useful 3D reconstructions

Techniques, Tricks, and Stratagems of Oral Cavity Computed Tomography and Magnetic Resonance Imaging

The oral cavity constitutes a complex anatomical area that can be affected by many devel-opmental, inflammatory, and tumoural diseases. MultiSlice Computed Tomography (MSCT) and Magnetic Resonance Imaging (MRI) currently represent the essential and complementary imaging techniques for detecting oral cavity abnormalities. Advanced MRI with diffusion-weighted imaging (DWI) and dynamic contrast-enhanced perfusion-weighted imaging (DCE-PWI) has recently increased the ability to characterise oral lesions and distinguish disease recurrences from post therapy changes. The analysis of the oral cavity area via imaging techniques is also complicated both by mutual close appositions of different mucosal surfaces and metal artifacts from dental materials. Nevertheless, an exact identification of oral lesions is made possible thanks to dynamic manoeuvres and specific stratagems applicable on MSCT and MRI acquisitions. This study summarises the currently available imaging techniques for oral diseases, with particular attention to the role of DWI, DCE-PWI, and dynamic manoeuvres. We also propose MSCT and MRI acquisition protocols for an accurate study of the oral cavity area

The OSIRIS-REx Visible and InfraRed Spectrometer (OVIRS): Spectral Maps of the Asteroid Bennu

The OSIRIS-REx Visible and Infrared Spectrometer (OVIRS) is a point spectrometer covering the spectral range of 0.4 to 4.3 microns (25,000-2300 cm-1). Its primary purpose is to map the surface composition of the asteroid Bennu, the target asteroid of the OSIRIS-REx asteroid sample return mission. The information it returns will help guide the selection of the sample site. It will also provide global context for the sample and high spatial resolution spectra that can be related to spatially unresolved terrestrial observations of asteroids. It is a compact, low-mass (17.8 kg), power efficient (8.8 W average), and robust instrument with the sensitivity needed to detect a 5% spectral absorption feature on a very dark surface (3% reflectance) in the inner solar system (0.89-1.35 AU). It, in combination with the other instruments on the OSIRIS-REx Mission, will provide an unprecedented view of an asteroid's surface.Comment: 14 figures, 3 tables, Space Science Reviews, submitte

Osteoporosis risk factors in HIV positive women with osteoporosis: A retrospective analysis

Multifactorial risk factors such as HIV/HCV co-infection and antiretroviral therapy (ARV) have been associated with osteoporosis in HIV+ women. We retrospectively analysed which known risk factors were associated with the diagnosis of osteoporosis, according to the WHO definition, in HIV positive women who were followed-up at the AIDS Centre of the University of Palermo, Italy between January 2011 and December 2014. Twenty-one HIV+ women with osteoporosis (13 HIV+ mono-infected and 8 HIV/HCV co-infected females) who underwent dual-energy X-ray absorptiometry (DXA) and liver stiffness assessment were included in the study. No significant differences between the HIV and HIV/HCV group were found regarding liver stiffness and lumbar/femoral osteoporosis scores. In a univariate analysis, we observed a positive linear correlation between LBD score (Lumbar Bone Density) with pre-fractures (p-value = 0.0082), smoke (p-value = 0.0008), alcohol (p-value < 0.0001) and ARV exposure score (p-value = 0.0039), while there were no significant negative linear correlations. In multivariate analysis, pre-fractures, smoke and alcohol were positive predictors of LBD score, while previous antiretroviral therapy (ARV) (years) score was a negative predictor compared to others. Univariate analysis showed a positive linear correlation between FDB (Femoral Bone Density) with smoke (p-value = 0.0303) and alcohol (p-value = 0.0050), while there were no significant negative linear correlations. In multivariate analysis, alcohol was a positive predictor of FDB score compared to others, while ARV score was a negative predictor compared to others. This preliminary study suggests that other factors besides ARV score and liver fibrosis may affect the skeletal system in osteoporotic women with HIV infection. Some of these factors, such as alcohol and smoking, are modifiable. Additional research into impact on osteoporosis in HIV women with osteoporosis is required