Neurovascular imaging: seeing the future more clearly

I am very happy to present the new journal titled Neurovascular Imaging (NVI), published by BioMed Central. The field of neurovascular imaging is a pivotal point at the intersection of neuroradiology, vascular neurology and vascular neurosurgery. Neurovascular research is a growing field and it is my opinion that a dedicated space for research in this field is necessary. In recent years, research in the field of neurovascular imaging has grown and changed through the exploration of both the morphological features associated with the pathology [1–3] and the pathways that lead to the early development of pathological conditions [4, 5]. In particular, the introduction of new CT and MR technologies opened new territories in the neurovascular imaging field [6–8]. Epidemiological analyses have shown that stroke is the third leading cause of death in the western world [9] and several recently published studies have underlined the link between the vessel (small and medium size) and brain disorders [10, 11]. The purpose of this journal will be to publish the latest research and educational papers about the key topics in neurovascular imaging. The main topics of focus for NVI include (but are not limited to): (1) Basis of pathology and technique (2) Carotid and vertebral artery, (3) Intracranial arterial circulation, (4) Stroke imaging, (5) Veins imaging, (6) Spine circulation, (7) Pediatric vascular disease. The journal will publish not only articles that cover "how to image" or "how to identify" some specific anatomy part or disease, but mainly scientific studies that explore the diagnostic process by using imaging. The vision is to consider the use of imaging as an advanced tool to perform the diagnosis of a disease and to identify associations between pathological conditions. The modality of publication of the articles in NVI is the open access publishing model [12, 13]; this approach has several advantages, including a wide readership resulting from unrestricted access. In the past, the traditional business model for scientific publishers relied on restricting access to published research in order to recoup the costs of the publication process. This approach was proven to work in the past but it is becoming apparent that the reality is rapidly changing and the necessity of restricting access to published research nowadays is debatable. It is well demonstrated that to produce "science," it is important for the unrestricted flow of information in order to develop the necessary critical mass of new ideas to make a "quantum leap" the research [14]. The Editorial Board is composed by world-renowned leaders in the various fields of neurovascular imaging, some of whom are some of the fathers of this topic. Readers can be assured that NVI will be home to highquality research submitted and reviewed by the leading people in the field. In conclusion, I have high hopes for Neurovascular Imaging; its duty is complex, but I am sure that NVI will achieve its goals in the best way

Is there an association between leukoaraiosis volume and diabetes?

Objectives: The relation between white matter loss (WML) and diabetes is still debated. The aim of this study was to investigate the correlation between typical WML— and diabetesrelated magnetic resonance imaging (MRI) findings in a cohort of patients scheduled for carotid endarterectomy (CEA). Materials and methods: Ninety-three consecutive patients (mean age 71 ± 9 years; male 71) were included in a single-centre retrospective study. All the patients underwent MRI as baseline evaluation prior to CEA. A neuroradiologist blinded to the presence of risk factors calculated WML volume and number of lesions on FLAIR images using a semi-automated segmentation technique. Receiver operating characteristics analysis was performed to search for any association between WML volume and the number of WML lesions. The Mann—Whitney tests were used to determine significant WML differences between diabetic and non-diabetic patients. Logistic regression analysis was performed to evaluate the potential association of other variables. Results: The prevalence of diabetes was 20.4% (n = 19). WML volume and number of WML lesions were significantly associated with diabetes (P = 0.001). A statistically significant difference in WML volume was found between diabetic and non-diabetic patients (P < 0.0001). Only diabetes, among all the investigated variables (WML volume, CAD status, age, smoking status, gender, hypertension, hyperlipidemia, diabetes) was significantly associated with WML (P = 0.0001)

Effects of animal welfare measures on milk sheep and goat quality and dairy production in Sardinia

This paper will explore how the massive application of animal welfare on the sheep sector in Sardinia has been implemented both from the point of view of the effectiveness and efficiency of the interventions of the EU measure which has made it possible to evaluate the results, both through an analysis of the perception consumers have of the concept of animal welfare on the sheep sector. Wide space has been given to the deepening of the concept of animal welfare is as ethical concept, whether scientific, both as a Community definition. After having extensively analyzed the Community legislation governing the implementation of animal welfare in Europe, have been taken into account the data of the experience gathered in Sardinia by the sheep sector in recent 10 years. Therefore, the present research aims to: (1) highlight the features of this complex and significant policy, which has undergone a few changes over the years; (2) examine the multiple and profound reasons to the source of that policy; (3) see if any ambitious objectives were achieved at the end of the second implementation period in 2015 and (4) identify whether and how the implementation of measures on animal welfare has been instrumental in pushing the livestock industry toward a more modern and rational; (5) try to outline future perspectives from the results achieved. Nevertheless, the current market trends will be examined again to categorize new perspectives in a bi-dimensional reality opportunities and weaknesses to overcome. To describe some prospects in the sixth chapter were analyzed the opinions of stakeholders, to examine in depth the critical remarks on the necessity of the measure and on the advisability of commercial exploitation, and consumers, to analyze in the context of product demand any propensity to purchase products resulting from the respect of animal welfare. Research has shown on an economic basis that the existence of a measure that guarantees public good "welfare of sheep" is still fully justified. Application analytics measure demonstrates the high value and the results achieved through this valuable policy designed and implemented by the region of Sardinia. The future financial situation is the first tough step ahead. The amount and manner of access to financial resources by farmers could drastically change, consider new emergencies facing Europe and the profound change in the global scenario. Whatever the future scenario, the opportunity must be grasped today. On the basis of the new legislation on the CMO, more organizational innovations are possible to improve the Organization of producers and organizing inter-professional and learn to use new tools to plan production and regulate supply, as established in particular for the milk

Single injection dual phase CBCT technique ameliorates results of trans-arterial chemoembolization for hepatocellular cancer

Cone-beam CT (CBCT) application to the field of trans-arterial chemoembolization has been recently the focus of several researches. This imaging modality is performed with a rotation of the C-arm around the patient, without needs of patient repositioning. Datasets are immediately processed, obtaining volumetric CT-like images with the possibility of post-processing and reconstruction of images. Dual phase CBCT recently introduced in clinical practice consists in a first arterial acquisition followed by a delayed acquisition corresponding to a venous phase. The introduction of this feature has overcome the limit of single-phase acquisitions, allowing lesions characterization. Moreover these recent advantages have several intra-procedural implications. Detailed technical and acquisition parameters will be widely exposed in this review with particular attention to: catheter positioning, acquisition delay, injection parameters, patient positioning and contrast dilution. Comparison with standard of practice second line imaging [multidetector computer tomography (MDCT) and MDCT/arteriography] demonstrate the capability of detecting occult nodules providing some clinical implications thus potentially identifying a sub set of patients with aggressive disease behaviour. Other intra-procedural advantages of dual phase CBCT usage consist in a better tumor feeder visualization, reduction of proper DSA and fluoroscopic time, suggestion the presence of an extrahepatic parasitic feeder thus resulting in a more accurate treatment. Finally, the volumetrical intraprocedural evaluation of accumulation of embolic agent has proved to be correlate with treatment response if compared with MRI

The birth and rise of a craniopharyngioma: the radiological evolution of an incidental craniopharyngioma detected on serial MRI during medical treatment of a macroprolactinoma

This case demonstrates the rare coexistence of a prolactinoma with craniopharyngioma and documents its radiological growth. This case suggests that patients with pituitary neoplasms should be followed closely and although prolactinomas can often be managed medically, a coexistent other lesion may require surgery for histological assessment and to reduce mass effect

Risk Factors for Immediate and Delayed-Onset Fever After Percutaneous Transhepatic Biliary Drainage

Objectives To prospectively investigate the pre and intraprocedural risk factors for immediate (IF) and delayedonset (DOF) fever development after percutaneous transhepatic biliary drainage (PTBD). Methods Institutional review board approval and informed patient consent were obtained. Between February 2013 and February 2014, 97 afebrile patients (77 at the Sapienza University of Rome, Italy and 20 at the Sun Yatsen University of Guangzhou, China) with benign (n = 31) and malignant (n = 66) indications for a first PTBD were prospectively enrolled. Thirty pre- and intra-procedural clinical/radiological characteristics, including the amount of contrast media injected prior to PTBD placement, were collected in relation to the development of IF (within 24 h) or DOF (after 24 h). Fever was defined as C37.5 C. Binary logistic regression analysis was used to assess independent associations with IF and DOF. Results Fourteen (14.4 %) patients developed IF and 17 (17.5 %) developed DOF. At multivariable analysis, IF was associated with pre-procedural absence of intrahepatic bile duct dilatation (OR 63.359; 95 % CI 2.658–1510.055; P = 0.010) and low INR (OR 4.7 9 10-4 ; 95 % CI 0.000–0.376; P = 0.025), while DOF was associated with unsatisfactory biliary drainage at the end of PTBD (OR 4.571; 95 % CI 1.161–17.992; P = 0.030)

Volumetric analysis of carotid plaque components and cerebral microbleeds: a correlative study

PURPOSE: The purpose of this work was to explore the association between carotid plaque volume (total and the subcomponents) and cerebral microbleeds (CMBs). MATERIALS AND METHODS: Seventy-two consecutive (male 53; median age 64) patients were retrospectively analyzed. Carotid arteries were studied by using a 16-detector-row computed tomography scanner whereas brain was explored with a 1.5 Tesla system. CMBs were studied using a T2*-weighted gradient-recalled echo sequence. CMBs were classified as from absent (grade 1) to severe (grade 4). Component types of the carotid plaque were defined according to the following Hounsfield unit (HU) ranges: lipid less than 60 HU; fibrous tissue from 60 to 130 HU; calcification greater than 130 HU, and plaque volumes of each component were calculated. Each carotid artery was analyzed by 2 observers. RESULTS: The prevalence of CMBs was 35.3%. A statistically significant difference was observed between symptomatic (40%) and asymptomatic (11%) patients (P value = .001; OR = 6.07). Linear regression analysis demonstrated an association between the number of CMBs and the symptoms (P = .0018). Receiver operating characteristics curve analysis found an association between the carotid plaque subcomponents and CMBs (Az = .608, .621, and .615 for calcified, lipid, and mixed components, respectively), and Mann-Whitney test confirmed this association in particular for the lipid components (P value = .0267). CONCLUSIONS: Results of this study confirm the association between CMBs and symptoms and that there is an increased number of CMBs in symptomatic patients. Moreover, we found that an increased volume of the fatty component is associated with the presence and number of CMBs

Skeletal Muscle Disease: Imaging Findings Simplified

Skeletal muscle is a major anatomic structural component of the human body. Myopathy, defined as skeletal muscle disease, may offend any of the body's 650 muscles and encompasses an extended array of acute and chronic abnormalities. Muscle disease can be categorized according to etiology as congenital, traumatic, infectious, or neoplastic. The concept of the diversity of multiple muscular disease processes signifies an important role for imaging in the detection and characterization of myopathy. However, despite the exquisite physiological properties of skeletal muscle, muscle imaging has not received attention equal to that of bones and joints. Accordingly, this article provides an indication of the most suitable imaging modalities for myopathy and reviews a multitude of primary and systemic muscle derangements, with an emphasis on magnetic resonance (MR) imaging findings. Because these patterns of MR imaging abnormality bespeak the widespread nature of myopathy, we illustrate typical examples of muscle disease processes to simplify diagnosis