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Risonanza Magnetica vs ecocardiografia nello studio della funzione ventricolare sinistra nel rimodellamento post-ischemico
No full textDegenerative disease of the spine
No full textDegenerative disease of the spine is a definition that includes a wide spectrum of degenerative abnormalities. Degeneration involves bony structures and the intervertebral disk, although many aspects of spine degeneration are strictly linked because the main common pathogenic factor is identified in chronic overload. During life the spine undergoes continuous changes as a response to physiologic axial load. These age-related changes are similar to pathologic degenerative changes and are a common asymptomatic finding in adults and elderly persons. A mild degree of degenerative changes is paraphysiologic and should be considered pathologic only if abnormalities determine symptoms. Imaging allows complete evaluation of static and dynamic factors related to degenerative disease of the spine and is useful in diagnosing the different aspects of spine degeneration
Spinal injury in sport
No full textSpinal injuries are very common among professional or amateur athletes. Spinal sport lesions can be classified in overuse and acute injuries. Overuse injuries can be found after years of repetitive spinal load during sport activity; however specific overuse injuries can also be found in adolescents. Acute traumas are common in contact sports. Most of the acute injuries are minor and self-healing, but severe and catastrophic events are possible. The aim of this article is to review the wide spectrum of spinal injuries related to sport activity, with special regard to imaging finding. (c) 2007 Elsevier Ireland Ltd. All rights reserved
Radiological strategy in acute stroke in children
No full textThe aim of the study was to estimate the preponderance of patterns of pediatric stroke, ischemic or hemorrhagic, their etiologies and the correct diagnostic protocol for acute management. Forty-one consecutive pediatric patients (age range 5-16 years) with an acute stroke observed in acute phase during a 10-year period, were retrospectively evaluated. Twenty-three patients underwent magnetic resonance imaging (MRI), 3 cases were studied by computed tomography (CT) without MRI, and 15 underwent both CT and MRI studies. In 9 cases, intra-arterial digital subtraction angiography (IADSA) was performed after non-invasive preliminary assessment. Seventeen hemorrhagic (41%) and 24 ischemic (59%) strokes were found. Among hemorrhagic forms, 5 cases were due to arteriovenous malformation (AVM), 7 to cavernoma, and 2 to aneurysm. Among ischemic forms, 2 were due to sickle-cell disease, 1 to hyperomocysteinemia, 1 to moyamoya syndrome, 1 to pseudoxantoma elasticum, 3 to prothrombotic state, 1 to Fabry's disease, 1 concomitant with CO intoxication, 5 to venous sinus thrombosis, and 4 to cardio-embolic state. Etiology remains unknown in 8 cases (20.5%). This study shows a moderate prevalence of ischemic over hemorrhagic strokes. Moreover, personal experience suggests that MRI is always more informative than CT and in selected cases should be the first-choice examination in the acute phase. (C) 2009 Elsevier Ireland Ltd. All rights reserved
Possibilità e limiti della risonanza magnetica nell’iter diagnostico della cardiomiopatia aritmogena del ventricolo destro
No full textRelated Articles Sciatica: treatment with intradiscal and intraforaminal injections of steroid and oxygen-ozone versus steroid only
No full textPURPOSE: To prospectively compare the clinical effectiveness of intraforaminal
and intradiscal injections of a mixture of a steroid, a local anesthetic, and
oxygen-ozone (O(2)-O(3)) (chemodiscolysis) versus intraforaminal and intradiscal
injections of a steroid and an anesthetic in the management of radicular pain
related to acute lumbar disk herniation.
MATERIALS AND METHODS: Medical Ethical Committee approval and informed consent
were obtained. One hundred fifty-nine patients (86 men, 73 women; age range,
18-71 years) were included and were randomly assigned to two groups.
Seventy-seven patients (group A) underwent intradiscal and intraforaminal
injections of a steroid and an anesthetic, and 82 patients (group B) underwent
the same treatment with the addition of an O(2)-O(3) mixture. Procedures were
performed with computed tomographic guidance. An Oswestry Low Back Pain
Disability Questionnaire was administered before treatment and at intervals, the
last at 6-month follow-up. Patients and clinicians were blinded as to which
treatment was performed. Results were compared with the chi(2) test.
RESULTS: After 6 months, treatment was successful in 36 (47%) patients in group A
and in 61 (74%) patients in group B. The difference was significant (P < .01).
CONCLUSION: Intraforaminal and intradiscal injections of a steroid, an
anesthetic, and O(2)-O(3) are more effective at 6 months than injections of only
a steroid and an anesthetic in the same sites
Mucoid metaplastic-degeneration of anterior cruciate ligament
No full textAim. Mucoid degeneration of the interior cruciate ligament (ACL) is a pathological state not Net well morphologically defined, involving people without history of knee instability or significant trauma, and causing important pain. The aim of this study was to define the histopathological and radiographic features of this pathological condition. Methods. Analysis of 1 215 knee magnetic resonance (MR) examinations found 64 cases (5.3%) of ACL mucoid metaplastic-degeneration (MMD), subsequently all subjects underwent surgical and arthroscopic validation. MR examinations have been performed using a dedicate system provided with a permanent magnet of 0.18 T and with a dedicate coil of 12 cm of field of view (FOV) or an high field instrument with 1.5 T. Radiological criteria to define ACL MMD were based essentially on increased signal intensity in T2W sequences and in STIR ones, as in T1W scans the ligament showed an intermediate signal. Results. ACL MMD was diagnosed in 36 males and 28 females, with a mean age of 44 years. "Segmentary MMD" was found in I I subjects (17.2%) commonly affecting the postero-lateral bundle of the ligament without femoral or tibial spongious mucoid intrusion. "Total MMD (involving the entire ligament and accompanied with femoral or tibial intrusion) was found in 53 subjects (82.8%). Conclusion. The comparison between histopathological and MR findings suggests that the commonly called ACL mucoid degeneration (ACL MD) should be better defined as mucoid metaplastic degeneration (MMD)
Assessment of inflammatory activity in Crohn's disease by means of dynamic contrast-enhanced MRI
No full textPurpose. Our aim was to perform a dynamic study of contrast enhancement of the intestinal wall in patients with Crohn's disease to quantitatively assess local inflammatory activity. Materials and methods. We studied a population of 50 patients with histologically proven Crohn's disease. Magnetic resonance imaging (MRI) was performed using a 1.5-T magnet with a phased-array coil and acquisition of T2-weighted single-shot fast spin echo (SSFSE) half Fourier sequences before intravenous administration of gadolinium, and T1-weighted fast spoiled gradient (FSPGR) fat-saturated sequences before and after contrast administration. Before the examination, patents received oral polyethylene glycol (PEG) (1,000 ml for adults; 10 ml/Kg of body weight for children). Regions of interest (ROI) were placed on the normal and diseased intestinal wall to assess signal intensity and rate of increase in contrast enhancement over time. Data were compared with the Crohn's Disease Activity Index (CDAI). Results. The diseased bowel wall showed early and intense uptake of contrast that increases over time until a plateau is reached. In patients in the remission phase after treatment, signal intensity was only slightly higher in diseased bowel loops than in healthy loops. There was a significant correlation between the peak of contrast uptake and CDAI Conclusions. Dynamic MRI is a good technique for quantifying local inflammatory activity of bowel wall in patients with Crohn's disease
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