Magnetic resonance angiography offers many techniques for study of the carotid district. Time of ... more Magnetic resonance angiography offers many techniques for study of the carotid district. Time of flight (TOF) is the most widely used technique and can be employed to obtain single slice (2D) or volumetric (3D) images. Our study compared a widely used technique like 2D TOF with the relatively new technique of 3D FGE with bolus administration of contrast medium. From our experience in 20 patients, we conclude that MR angiography with the contrast enhanced 3D FGE offers more detailed information than the 2D TOF technique, thereby justifying its minimum invasiveness and the costs linked to contrast administration. The new technique is a valid alternative to DSA in solving doubtful cases and establishing appropriate treatment strategies.
Diagnostic imaging plays an important role in the postoperative evaluation of the rotator cuff, a... more Diagnostic imaging plays an important role in the postoperative evaluation of the rotator cuff, as pain and disability may occur or persist after treatment. Postoperative imaging is therefore of paramount importance for clinicians before planning additional treatments. Multimodality imaging of the postoperative shoulder includes radiography, magnetic resonance (MR) imaging, MR arthrography, computed tomography (CT), CT arthrography, and ultrasound. Correct interpretation of imaging findings of the postoperative shoulder necessitates that the radiologist be familiar with the various treatment strategies, their possible complications and sources of failure, knowledge of normal and abnormal postoperative findings, and awareness of the advantages and weaknesses of the different imaging techniques. Imaging findings, however, should always be correlated with the clinical presentation because postoperative imaging abnormalities do not necessarily correlate with symptoms. This manuscript is...
The follow-up of an operated tendon is primarily clinical, although clinical examination may not ... more The follow-up of an operated tendon is primarily clinical, although clinical examination may not be sufficient in the presence of certain complications. The imaging techniques are of great value not only in the diagnosis of tendon pathologies, but also as an adjunct to clinical evaluation. This is particularly true in the follow-up of patients submitted to surgical tendon reconstruction, by monitoring morphological effects of different interventions and evaluating tendon healing processes. Interpretation of imaging findings requires knowledge of the imaging appearance of the operated tendon during the healing phase, to distinguish between normal postsurgical changes and real pathology, as well as knowledge of surgical technique, postoperative course (including type of prescribed therapy) and possible postoperative complications. The most important imaging modalities to examine the Achilles tendon are ultrasound and magnetic resonance imaging. This article gives a review of some of t...
We aimed to evaluate interobserver agreement in the definition of spine instability among spine n... more We aimed to evaluate interobserver agreement in the definition of spine instability among spine neuroradiologists with or without experience in dynamic magnetic resonance imaging (MRI). Two expert neuroradiologists and two residents retrospectively evaluated the pre-operative dynamic MRI examinations of patients with vertebral instability. Segmental motion, defined as excessive (more than 3 mm) translational motion from supine to upright, was investigated in 103 subjects (309 segments) using kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration, facet joint osteoarthritis, and ligament flavum hypertrophy. These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. The agreement among the neuroradiologists was calculated using the kappa coefficient. All patients had neurosurgical intervention to stabilize the spine. Agree...
We prospectively assessed the diagnostic criteria of morphologic MRI study (MMS) and the accuracy... more We prospectively assessed the diagnostic criteria of morphologic MRI study (MMS) and the accuracy of DWI and related ADC values (DWI-ADC) versus intervertebral disk volumetric analysis (IDVA) for predicting shrinkage of lumbar disk herniation treated with oxygen-ozone (O2-O3) diskolysis. Sixty-eight patients (36 men and 32 women; mean age 39) with lumbosciatica underwent O2-O3 diskolysis. The six-month MRI follow-up was performed with FSE-T2 and T2-fat, SE-T1 and DWI-weighted images. IDVA was determined using OsiriX®. Diagnostic criteria and accuracy were evaluated with regards to DWI and related ADC in detecting response to ozone therapy. Fifty-eight of 68 patients had successful outcomes (responders), whereas ten patients showed unsatisfactory outcomes (non-responders). MMS showed that a centrally located herniated disk and grade 1 nerve root compression were more common in the responder group (p < 0.05). DWI-ADC and IDVA showed statistically significant shrinkage in the sixth ...
Imaging of Brain Metabolism Spine and Cord Interventional Neuroradiology Free Communications, 1989
Magnetic Resonance (MR) imaging has been proved to be useful in cardiovascular investigations (He... more Magnetic Resonance (MR) imaging has been proved to be useful in cardiovascular investigations (Herfkens et al 1983, Soila et al 1986). In atherosclerotic pathology an accurate imaging study is important for providing opportune surgery or medical therapy (Higgins et al 1984). Angiography is considered the most sensitive diagnostic procedure but does not allow the precise characterization of stenotic lesions and presents some risks.
Case reports Case 1 A 15-year-old male was admitted in October 1997 because of left jacksonian se... more Case reports Case 1 A 15-year-old male was admitted in October 1997 because of left jacksonian seizure. Three days after he had entered the hospital, tonico-clonic seizures and loss of consciousness appeared under the physician's eyes. Plain and enhanced CT and plain and enhanced MR (0.2-T) examinations of the brain were performed. CT scans showed a 1-cm circular hyperdense lesion located in
We investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis... more We investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis on the value of gadolinium-enhanced fluid-attenuated inversion recovery (FLAIR) sequence. Twenty-seven patients with clinical suspicion of infectious meningitis were included. MRI was performed within 3 h of clinical evaluation. For all patients, T1-weighted spin-echo, dual-echo T2-weighted fast-spin-echo and FLAIR sequences were performed, followed by gadolinium-enhanced T1-weighted spin-echo and FLAIR sequences. Final diagnosis was based on the clinical findings and the analysis of cerebrospinal fluid, obtained by lumbar puncture after the MRI. Infectious meningitis was confirmed in 12 patients. In all of these patients of the plain studies, FLAIR was positive in only four patients. MRI gadolinium-enhanced FLAIR showed abnormal meningeal enhancement in all 12 patients, while gadolinium-enhanced T1-weighted spin-echo was positive only in six cases. There were no false-positive or false-negative results. It is concluded that MRI could have an important role in the early screening for infectious meningitis, provided a gadolinium-enhanced FLAIR sequence is used.
In pathologies such as progressive ataxias, clinical criteria are often not enough to provide the... more In pathologies such as progressive ataxias, clinical criteria are often not enough to provide the correct diagnosis. Therefore, we studied by means of MRI 30 normal volunteers and 19 patients affected by different progressive ataxias, diagnosed by typical standards. On all the subjects measurements were performed in order to identify normal and pathological ranges. Our experience confirms that typical involvement can be detected in the different kinds of progressive ataxias. Peculiar compromissions were found in spinocerebellar diseases, able to differentiate them from the forms mostly involving the cerebellum and brainstem. The differentiation between typical Friedreich and non-Friedreich diseases can also be suggested in most cases.
Spinal injuries are very common among professional or amateur athletes. Spinal sport lesions can ... more Spinal 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.
is a disease usually related to chronic alcoholism. The Alessandro Bozzao clinical diagnosis is o... more is a disease usually related to chronic alcoholism. The Alessandro Bozzao clinical diagnosis is often difficuft to establish, and CT is unable to provide specific Alessandra Splendiani findings. MR follow-up studies in five patients affected by Wemicke encephalopathy Carlo Masciocchi were performed with the aim of establishing the sensitivity of MR in depicting the typical
British Journal of Medicine and Medical Research, 2016
Goldenhar syndrome (GS) is a poly-malformation syndrome, also defined as oculo-auricolovertebral ... more Goldenhar syndrome (GS) is a poly-malformation syndrome, also defined as oculo-auricolovertebral dysplasia with hemifacial microsomia. It is a rare congenital defect involving first and second branchial arches. The aetiology is not known. The most supported hypothesis is based on the abnormal embryonic vascular supply after mesodermal migration. Autosomal dominant, autosomal recessive and multifactorial modes of inheritance have been reported. We report the case of a female neonate affected by hemifacial microsomia and presence of pre-auricular tragi. Patients were subjected to computed tomography scan and MRI that revealed a mandibular unilateral hypoplasia without association of skeleton, brain and ocular alteration. The purpose of our study was to define the important role of the CT and MRI in the diagnosis of this polymarformation syndrome.
We aimed to evaluate interobserver agreement in the definition of spine instability among spine n... more We aimed to evaluate interobserver agreement in the definition of spine instability among spine neuroradiologists with or without experience in dynamic magnetic resonance imaging (MRI). Two expert neuroradiologists and two residents retrospectively evaluated the pre-operative dynamic MRI examinations of patients with vertebral instability. Segmental motion, defined as excessive (more than 3 mm) translational motion from supine to upright, was investigated in 103 subjects (309 segments) using kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration, facet joint osteoarthritis, and ligament flavum hypertrophy. These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. The agreement among the neuroradiologists was calculated using the kappa coefficient. All patients had neurosurgical intervention to stabilize the spine. Agree...
Magnetic resonance (MR) imaging provides detailed evaluation of cardiovascular structures, due to... more Magnetic resonance (MR) imaging provides detailed evaluation of cardiovascular structures, due to high intrinsic contrast between flowing blood and vessel's lumen. Early application have shown the clinical validity of the technique, with non-invasive, multiplanar imaging of large and medium sized vessels. In this study we evaluate the capabilities of MR in screening out patients with thoracic aorta enlargement. Examination has been performed in 16 patients, employing a 0.5 T superconductive unit, and acquiring images on axial, sagittal and coronal planes with 7 mm slice thickness. In 15 cases it was possible to detect the pathology and to characterize it according to type, location and extension. In 1 case it was no possible to make an accurate diagnosis for the presence of movement artefacts, due to poor patient's cooperation. In dissecting aneurysms the true and false lumen may be differentiated, with a good visualization of the intimal flap. The relation between the origi...
The aim of the study was to estimate the preponderance of patterns of pediatric stroke, ischemic ... more The 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&amp;amp;amp;amp;amp;amp;amp;amp;#39;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.
Background: Gene expression databases are key resources for microarray data management and analys... more Background: Gene expression databases are key resources for microarray data management and analysis and the importance of a proper annotation of their content is well understood.
Magnetic resonance angiography offers many techniques for study of the carotid district. Time of ... more Magnetic resonance angiography offers many techniques for study of the carotid district. Time of flight (TOF) is the most widely used technique and can be employed to obtain single slice (2D) or volumetric (3D) images. Our study compared a widely used technique like 2D TOF with the relatively new technique of 3D FGE with bolus administration of contrast medium. From our experience in 20 patients, we conclude that MR angiography with the contrast enhanced 3D FGE offers more detailed information than the 2D TOF technique, thereby justifying its minimum invasiveness and the costs linked to contrast administration. The new technique is a valid alternative to DSA in solving doubtful cases and establishing appropriate treatment strategies.
Diagnostic imaging plays an important role in the postoperative evaluation of the rotator cuff, a... more Diagnostic imaging plays an important role in the postoperative evaluation of the rotator cuff, as pain and disability may occur or persist after treatment. Postoperative imaging is therefore of paramount importance for clinicians before planning additional treatments. Multimodality imaging of the postoperative shoulder includes radiography, magnetic resonance (MR) imaging, MR arthrography, computed tomography (CT), CT arthrography, and ultrasound. Correct interpretation of imaging findings of the postoperative shoulder necessitates that the radiologist be familiar with the various treatment strategies, their possible complications and sources of failure, knowledge of normal and abnormal postoperative findings, and awareness of the advantages and weaknesses of the different imaging techniques. Imaging findings, however, should always be correlated with the clinical presentation because postoperative imaging abnormalities do not necessarily correlate with symptoms. This manuscript is...
The follow-up of an operated tendon is primarily clinical, although clinical examination may not ... more The follow-up of an operated tendon is primarily clinical, although clinical examination may not be sufficient in the presence of certain complications. The imaging techniques are of great value not only in the diagnosis of tendon pathologies, but also as an adjunct to clinical evaluation. This is particularly true in the follow-up of patients submitted to surgical tendon reconstruction, by monitoring morphological effects of different interventions and evaluating tendon healing processes. Interpretation of imaging findings requires knowledge of the imaging appearance of the operated tendon during the healing phase, to distinguish between normal postsurgical changes and real pathology, as well as knowledge of surgical technique, postoperative course (including type of prescribed therapy) and possible postoperative complications. The most important imaging modalities to examine the Achilles tendon are ultrasound and magnetic resonance imaging. This article gives a review of some of t...
We aimed to evaluate interobserver agreement in the definition of spine instability among spine n... more We aimed to evaluate interobserver agreement in the definition of spine instability among spine neuroradiologists with or without experience in dynamic magnetic resonance imaging (MRI). Two expert neuroradiologists and two residents retrospectively evaluated the pre-operative dynamic MRI examinations of patients with vertebral instability. Segmental motion, defined as excessive (more than 3 mm) translational motion from supine to upright, was investigated in 103 subjects (309 segments) using kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration, facet joint osteoarthritis, and ligament flavum hypertrophy. These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. The agreement among the neuroradiologists was calculated using the kappa coefficient. All patients had neurosurgical intervention to stabilize the spine. Agree...
We prospectively assessed the diagnostic criteria of morphologic MRI study (MMS) and the accuracy... more We prospectively assessed the diagnostic criteria of morphologic MRI study (MMS) and the accuracy of DWI and related ADC values (DWI-ADC) versus intervertebral disk volumetric analysis (IDVA) for predicting shrinkage of lumbar disk herniation treated with oxygen-ozone (O2-O3) diskolysis. Sixty-eight patients (36 men and 32 women; mean age 39) with lumbosciatica underwent O2-O3 diskolysis. The six-month MRI follow-up was performed with FSE-T2 and T2-fat, SE-T1 and DWI-weighted images. IDVA was determined using OsiriX®. Diagnostic criteria and accuracy were evaluated with regards to DWI and related ADC in detecting response to ozone therapy. Fifty-eight of 68 patients had successful outcomes (responders), whereas ten patients showed unsatisfactory outcomes (non-responders). MMS showed that a centrally located herniated disk and grade 1 nerve root compression were more common in the responder group (p < 0.05). DWI-ADC and IDVA showed statistically significant shrinkage in the sixth ...
Imaging of Brain Metabolism Spine and Cord Interventional Neuroradiology Free Communications, 1989
Magnetic Resonance (MR) imaging has been proved to be useful in cardiovascular investigations (He... more Magnetic Resonance (MR) imaging has been proved to be useful in cardiovascular investigations (Herfkens et al 1983, Soila et al 1986). In atherosclerotic pathology an accurate imaging study is important for providing opportune surgery or medical therapy (Higgins et al 1984). Angiography is considered the most sensitive diagnostic procedure but does not allow the precise characterization of stenotic lesions and presents some risks.
Case reports Case 1 A 15-year-old male was admitted in October 1997 because of left jacksonian se... more Case reports Case 1 A 15-year-old male was admitted in October 1997 because of left jacksonian seizure. Three days after he had entered the hospital, tonico-clonic seizures and loss of consciousness appeared under the physician's eyes. Plain and enhanced CT and plain and enhanced MR (0.2-T) examinations of the brain were performed. CT scans showed a 1-cm circular hyperdense lesion located in
We investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis... more We investigated the accuracy of MRI in the early diagnosis of infectious meningitis with emphasis on the value of gadolinium-enhanced fluid-attenuated inversion recovery (FLAIR) sequence. Twenty-seven patients with clinical suspicion of infectious meningitis were included. MRI was performed within 3 h of clinical evaluation. For all patients, T1-weighted spin-echo, dual-echo T2-weighted fast-spin-echo and FLAIR sequences were performed, followed by gadolinium-enhanced T1-weighted spin-echo and FLAIR sequences. Final diagnosis was based on the clinical findings and the analysis of cerebrospinal fluid, obtained by lumbar puncture after the MRI. Infectious meningitis was confirmed in 12 patients. In all of these patients of the plain studies, FLAIR was positive in only four patients. MRI gadolinium-enhanced FLAIR showed abnormal meningeal enhancement in all 12 patients, while gadolinium-enhanced T1-weighted spin-echo was positive only in six cases. There were no false-positive or false-negative results. It is concluded that MRI could have an important role in the early screening for infectious meningitis, provided a gadolinium-enhanced FLAIR sequence is used.
In pathologies such as progressive ataxias, clinical criteria are often not enough to provide the... more In pathologies such as progressive ataxias, clinical criteria are often not enough to provide the correct diagnosis. Therefore, we studied by means of MRI 30 normal volunteers and 19 patients affected by different progressive ataxias, diagnosed by typical standards. On all the subjects measurements were performed in order to identify normal and pathological ranges. Our experience confirms that typical involvement can be detected in the different kinds of progressive ataxias. Peculiar compromissions were found in spinocerebellar diseases, able to differentiate them from the forms mostly involving the cerebellum and brainstem. The differentiation between typical Friedreich and non-Friedreich diseases can also be suggested in most cases.
Spinal injuries are very common among professional or amateur athletes. Spinal sport lesions can ... more Spinal 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.
is a disease usually related to chronic alcoholism. The Alessandro Bozzao clinical diagnosis is o... more is a disease usually related to chronic alcoholism. The Alessandro Bozzao clinical diagnosis is often difficuft to establish, and CT is unable to provide specific Alessandra Splendiani findings. MR follow-up studies in five patients affected by Wemicke encephalopathy Carlo Masciocchi were performed with the aim of establishing the sensitivity of MR in depicting the typical
British Journal of Medicine and Medical Research, 2016
Goldenhar syndrome (GS) is a poly-malformation syndrome, also defined as oculo-auricolovertebral ... more Goldenhar syndrome (GS) is a poly-malformation syndrome, also defined as oculo-auricolovertebral dysplasia with hemifacial microsomia. It is a rare congenital defect involving first and second branchial arches. The aetiology is not known. The most supported hypothesis is based on the abnormal embryonic vascular supply after mesodermal migration. Autosomal dominant, autosomal recessive and multifactorial modes of inheritance have been reported. We report the case of a female neonate affected by hemifacial microsomia and presence of pre-auricular tragi. Patients were subjected to computed tomography scan and MRI that revealed a mandibular unilateral hypoplasia without association of skeleton, brain and ocular alteration. The purpose of our study was to define the important role of the CT and MRI in the diagnosis of this polymarformation syndrome.
We aimed to evaluate interobserver agreement in the definition of spine instability among spine n... more We aimed to evaluate interobserver agreement in the definition of spine instability among spine neuroradiologists with or without experience in dynamic magnetic resonance imaging (MRI). Two expert neuroradiologists and two residents retrospectively evaluated the pre-operative dynamic MRI examinations of patients with vertebral instability. Segmental motion, defined as excessive (more than 3 mm) translational motion from supine to upright, was investigated in 103 subjects (309 segments) using kinetic MRI. Radiographic parameters which can help indicate segmental instability include disc degeneration, facet joint osteoarthritis, and ligament flavum hypertrophy. These three radiographic parameters were simultaneously evaluated, and the combinations corresponding to significant segmental instability at each level were determined. The agreement among the neuroradiologists was calculated using the kappa coefficient. All patients had neurosurgical intervention to stabilize the spine. Agree...
Magnetic resonance (MR) imaging provides detailed evaluation of cardiovascular structures, due to... more Magnetic resonance (MR) imaging provides detailed evaluation of cardiovascular structures, due to high intrinsic contrast between flowing blood and vessel's lumen. Early application have shown the clinical validity of the technique, with non-invasive, multiplanar imaging of large and medium sized vessels. In this study we evaluate the capabilities of MR in screening out patients with thoracic aorta enlargement. Examination has been performed in 16 patients, employing a 0.5 T superconductive unit, and acquiring images on axial, sagittal and coronal planes with 7 mm slice thickness. In 15 cases it was possible to detect the pathology and to characterize it according to type, location and extension. In 1 case it was no possible to make an accurate diagnosis for the presence of movement artefacts, due to poor patient's cooperation. In dissecting aneurysms the true and false lumen may be differentiated, with a good visualization of the intimal flap. The relation between the origi...
The aim of the study was to estimate the preponderance of patterns of pediatric stroke, ischemic ... more The 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&amp;amp;amp;amp;amp;amp;amp;amp;#39;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.
Background: Gene expression databases are key resources for microarray data management and analys... more Background: Gene expression databases are key resources for microarray data management and analysis and the importance of a proper annotation of their content is well understood.
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