1,721,062 research outputs found
Ruolo prognostico della colangio-RM con MDC epatospecifici nella colangite sclerosante primitiva (CSP).
No full textCaseous Calcification of the Mitral Annulus Associated with Severe Mitral Regurgitation: A Multimodality Diagnostic Approach
Full text linkCaseous calcification of the mitral annulus (CCMA) is a rare variant of mitral annular calcification, and a multimodality approach is advised to ensure an accurate diagnosis. We report a case of a patient with CCMA, associated with severe mitral regurgitation. An 82-year-old woman was admitted due to worsening heart failure. Transthoracic echocardiography revealed a fixed, hyperechogenic mass, accompanied by restriction of the posterior mitral leaflet, and subsequent severe mitral regurgitation. Transesophageal echocardiography demonstrated a restricted motion of the posterior mitral leaflet, because of a large, echogenic mass (15 mm × 11 mm), attached to the mitral annulus, vacuolated with a central echolucent aspect, lacking acoustic shadowing. Contrast-enhanced cardiac computed tomography identified a distinct oval mass (18 mm × 11 mm × 19 mm) presenting a central hypodense content and peripheral calcification, strongly suggestive of CCMA. Considering the patient’s profile, surgical valvular replacement was considered unsuitable. Therefore, a transcatheter edge-to-edge repair was performed, resulting in mild residual regurgitation
Frontal aslant tract and premotor connections underlying visuomotor processing in humans
No full textOne-and-a-Half Ventricle Repair as a Surgical Alternative to Fontan Revision in an Adult.
No full text
CT and MR Imaging of the Adrenal Glands in Cortisol-secreting Tumors
No full textCushing’s syndrome (CS), first described by the
neurosurgeon Harvey Cushing in the 1930s, is the result of
chronic glucocorticoid excess. In patients with adrenocorticotropic
hormone (ACTH)-dependent CS, bilateral
hyperplasia of the adrenal cortex occurs, while in those with
ACTH-independent primary CS, either adrenocortical tumors
or primary adrenal hyperplasia can be observed. Cortisolsecreting
adrenocortical tumors are more frequently
adenomas, while adrenal carcinoma accounts for only 5% of
cases. Unfortunately, no reliable endocrinological tests are
available and no specific tumor markers exist to differentiate
between benign and malignant adrenal tumors, so both
computed tomography (CT) and magnetic resonance (MR)
imaging studies are currently required to localize and define
adrenal lesions. Additional information to conventional
imaging can be obtained using 18F-fluoro-2-deoxyglucose
(FDG)-positron emission tomography (PET)/CT, while
percutaneous image-guided fine-needle aspiration cytology
(FNAC) in some cases has shown a high accuracy in detecting
malignancy and in confirming adrenal metastases. New PET
tracers with selective affinity for the adrenal tissue are still
under evaluation. Multidetector CT scan, with the combination
of unenhanced and dynamic scans, represents the single most
accurate modality for the detection and the characterization
of adrenal adenomas. In these lesions, chemical-shift MR
imaging produces a typical loss of signal intensity on out-ofphase
breath-hold gradient-echo images in lipid-rich
adenomas. For these lesions there is no difference between CT
and MR imaging, while MR chemical shift imaging is very
helpful in identifying the additional small group of adenomas
where intracellular lipid content is minimal
New perspective in the assessment of lumbar back pain: MR radiomic features as biomarkers of disc degeneration and protrusion.
No full textImaging studies in Cushing’s syndrome
No full textCushing’s syndrome (CS) is a rare (0.2%) cause of arterial hypertension, with an estimated annual incidence of less than 1 per 100,000. Primary hypercortisolism may be of pituitary or ectopic origin, or adreno-corticotropic hormone (ACTH)-independent. When iatrogenic causes of hypercortisolism (secondary) have been excluded, spontaneous CS should be considered, and several endocrinological tests should be performed, with the aim of distinguish between ACTH-dependent and independent CS. In this setting, preoperative imaging procedures are also required. The most frequent CS is pituitary disfunction, which is due to an excess of ACTH and subsequent hyperstimulation of the adrenal cortex, while cortisol-secreting adrenocortical tumors, and the rare primary nodular hyperplasia account for about 15-20% of cases. Both pituitary and adrenal imaging techniques, such as magnetic resonance imaging (MR) and multidetector computed tomography (CT) scan are usually performed. Invasive localizing procedures (selective inferior petrosal sinus sampling), nuclear medicine studies of the adrenal glands (131I-norcholesterol scintigraphy), positron emission tomography (PET), as well as 18F-fluoro-2-deoxyglucose (FDG)-PET/CT, are required only in selected cases
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