Italian Radiology's Response to the COVID-19 Outbreak

No abstract availabl

Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines

The mission of the Italian Society of Colorectal Surgery (SICCR) is to optimize patient care. Providing evidence-based practice guidelines is therefore of key importance. About the present report it concernes the SICCR practice guidelines for the diagnosis and treatment of diverticular disease of the colon. The guidelines are not intended to define the sole standard of care but to provide evidence-based recommendations regarding the available therapeutic options

Methods to Address Computed Tomography-Related Risk Factors in Oncology Patients: An Expert Opinion Based on Current Evidence

Background: The present paper is intended to be a practical guide organized by statements describing methods to reduce risks related to CT examinations in cancer patients. Methods: A panel of radiologists, oncologists and nephrologists were selected based on their publication records in the field and expertise. Ten clinical questions, which were derived from clinical needs and an integration of all the committee members' suggestions, were stated. The modified Delphi approach was used; it involved a detailed literature review and the collective judgement of experts, including electronic and face-to-face discussions. Results: Ten statements were derived from expert opinions based on the current literature, recently developed guidelines and technological advancements. Each statement is discussed in a short paragraph reporting the current key evidence. Conclusion: This paper addresses the clinical implications of performing numerous CT examinations in patients with cancer, providing clinicians with information regarding methods to reduce risk factors in this patient population

Preoperative staging of colorectal cancer using virtual colonoscopy: correlation with surgical results

The aim of this study was to evaluate the clinical usefulness of computed tomography colonography (CTC) in the preoperative staging in patients with abdominal pain for occlusive colorectal cancer (CRC) and to compare the results of CTC with the surgical ones

Lean body weight-tailored Iodinated contrast Injection in obese patient. boer versus James Formula

Purpose. To prospectively compare the performance of James and Boer formula in contrast media (CM) administration, in terms of image quality and parenchymal enhancement in obese patients undergoing CT of the abdomen. Materials and Methods. Fifty-five patients with a body mass index (BMI) greater than 35 kg/m2were prospectively included in the study. All patients underwent 64-row CT examination and were randomly divided in two groups: 26 patients in Group A and 29 patients in Group B. The amount of injected CM was computed according to the patient's lean body weight (LBW), estimated using either Boer formula (Group A) or James formula (Group B). Patient's characteristics, CM volume, contrast-to-noise ratio (CNR) of liver, aorta and portal vein, and liver contrast enhancement index (CEI) were compared between the two groups. For subjective image analysis readers were asked to rate the enhancement of liver, kidneys, and pancreas based on a 5-point Likert scale. Results. Liver CNR, aortic CNR, and portal vein CNR showed no significant difference between Group A and Group B (all P ≥ 0.177). Group A provided significantly higher CEI compared to Group B (P = 0.007). Group A and Group B returned comparable overall subjective enhancement values (3.54 and vs 3.20, all P ≥ 0.199). Conclusions. Boer formula should be the method of choice for LBW estimation in obese patients, leading to an accurate CM amount calculation and an optimal liver contrast enhancement in CT

A case report of a rare intramuscular granular cell tumor

Background: Granular cell tumors (GCTs) were firstly described by Weber in 1854 and 70 years later by Abrikossoff and classified as benign tumors. Originally considered muscle tumors, they have been identified as neural lesions, due to their close association with nerve and to their immunohystochemical characteristics. GCTs are uncommon tumors and they may arise in any part of the body; they have been mainly observed in tongue, chest wall and upper extremities; less frequent sites are larynx, gastrointestinal tract, breast, pituitary stalk and the female anogenital region. Here we report a case of GCT showing an uncommon localization such as the upper third of the right rectus muscle of the abdominal wall. Case presentation: A 45 year-old woman of Caucasian origin presented to the surgeon with a 6-month history of light pain in the upper third of the abdominal wall. Radiological exams (Ultrasonography, Computed Tomography and Contrast magnetic resonance imaging) showed a localized in the right rectus abdominis muscle. After excision, histological and immunohystochemical analysis, with the support of electron microscopy, allowed making diagnosis of granular cell tumor. Discussion: After fist description by Abrikosoff in 1926 of GCT like mesenchymal tumor of unknown origin, in recent years immunohystochemical techniques definitely demonstrated the histogenetic derivation of GCT from Schwann cells. Granular cell tumors are rare, small, slow-growing, solitary and painless subcutaneous nodules which behave in a benign fashion, but can have a tendency to recur; in rare cases they can metastasize, when they became malignant; there are some clinical and histological criteria to suspect the malignance of this tumor. Conclusion: It is important that clinicians, radiologists and pathologists are aware of the clinical presentation and histopathology of GCT for appropriate management, counselling and follow-up. In our case we had a complete radiological, morphological and immunohystochemical characterization of the lesion and a definitive diagnosis of benignity confirmed by electron microscopy

small bowel disease

Diagnostic imaging and in particular cross-sectional modalities (US, CT, and MR) have a critical and complementary role in diagnosis and management of small bowel diseases. Radiologists should be aware of advantages and disadvantages of each imaging test in order to choose the best option, considering the specific small bowel disease and the patient's characteristics (age, gender, clinical status). US is a powerful tool, especially in combination with oral (SICUS) and intravenous (CEUS) contrast agents. CT is the imaging modality of choice in the emergency setting (i.e., small bowel occlusion, ischemia, and, in some circumstances, bleeding). MR is the preferred imaging test in benign disorders, and in particular inflammatory bowel diseases (IBDs), because of multiparametric approach, evaluation of bowel motility, and lack of radiation exposure. A brief review of main findings in different pathological entities involving the small bowel is provided, in order to offer to radiologists the instruments for a correct diagnosis and for providing the clinicians with the necessary information for patient management

How technology can help in oncologic patient management during COVID-19 outbreak

No abstract availabl

Multi-modality imaging approach in a challenging case of surgically corrected partial anomalous pulmonary venous return and atrial tachycardia treated with radiofrequency ablation

Pulmonary anomalous venous return (PAPVR) is defined as a congenital anomaly in which at least one but not all of the pulmonary veins abnormally drain into a systemic vein or directly into the right atrium. Signs and symptoms related to this condition are due to the hemodynamic abnormalities secondary to left-to-right shunt and the possible presence of other associated cardiac anomalies (e.g., sinus venous atrial septal defect). Therefore, depending on the extent of the shunt, the clinical presentation of PAPVR is variable, ranging from asymptomatic patients to patients affected by severe heart failure with right-sided volume overload. PAPVR with a clinically significant shunt should be referred for surgical correction with different techniques depending on the presence of associated cardiac anomalies. We are presenting a case of partial anomalous venous return (PAPVR) in a 66-year-old man who underwent surgery 26 years ago to correct an anomalous venous connection between the right superior pulmonary vein (RSPV) and the superior vena cava (SVC) through a veno-atrial baffle. The patient was admitted to the emergency department due to atrial tachycardia. Trans-thoracic echocardiography (TTE) showed a dilated right ventricle (RV) with mild RV systolic dysfunction and pulmonary hypertension.Cardiac magnetic resonance (CMR) further confirmed the findings described by TTE and also demonstrated areas of fibrosis replacement in the hinge points. Cardiac computed tomography (CCT) was able to accurately depict and evaluate the surgically created veno-atrial baffle and also showed an anomalous connection between the left superior pulmonary vein (LSPV) and the brachiocephalic vein (BCV) through a vertical vein. The patient was successfully treated with radiofrequency ablation for his arrhythmia