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Biomedical subjects

C Ciccotosto

Publications and source records attributed to C Ciccotosto.

30 records · Page 2Linked to original sources
PubMed1990

[Magnetic resonance angiography of the pulmonary artery. Preliminary considerations].

The possibility was evaluated of imaging the pulmonary artery with MR angiography. Twenty healthy volunteers were studied using 3D FT gradient-echo sequences on the coronal plane, with post-processing by the maximum intensity projection method. TE and TR remaining short, flip angles were selected to increase pulmonary artery signal in contrast with hypointense adjacent tissues and vessels. Flip angle selection allowed the optimal differentiation between pulmonary artery and aorta with 15 degree-25 degree angles (range: 110.7 to 122 for the 15 degree flip angle and 158.7 to 182.1 for the 20 degree flip angle). The sequence was obtained on the coronal plane and the following parameters were employed: TR 0.03 s, TE 10 ms, flip angle 15 degree-20 degree, slice of the total volume 100 mm with 64 partitions, 256 x 256 matrix, 1 zoom factor, 1 acquisition. The patient was positioned with the right hemithorax raised by 30 degrees to visualize the common pulmonary artery and lying on his back, face upward, to visualize the right and left pulmonary arteries. Post-processing employed axial plane rotations from -45 degrees to +45 degrees, with 5 degrees step, and from 0 degrees to 180 degrees, with 15 degrees step. Angio-MR images of the pulmonary artery allowed the visualization of its main components, up to its right and left lobar branches. The main limitation of this technique consisted in its poor spatial resolution.

Adult↗
PubMedDate not supplied

[Magnetic resonance imaging of the brachial plexus. Anatomy].

The brachial plexus is a difficult region to evaluate with radiological techniques. MR imaging has great potentials for the depiction of the various anatomical structures of the brachial plexus--i.e., spinal ganglion, ventral nerve rami root exit of the neural foramina, trunks and cords. Moreover, MR imaging, thanks to its direct multiplanarity, to its excellent soft-tissue contrast, and to its lack of motion artifacts, allows good evaluation of pathologic conditions in the brachial plexus, especially traumas and cancers. On the contrary CT, in spite of its high spatial resolution and good contrast, cannot demonstrate the anatomical structures of the brachial plexus. US detects superficial structures, and conventional radiographs depict only indirect changes in the adjacent lung apex and skeletal structures. From November 1989 to May 1990, 20 normal volunteers (15 males and 5 females; average age: 35 years) were studied with MR imaging. Multisection technique was employed with a dedicated coil and a primary coil. The anatomical structures of the brachial plexus were clearly demonstrated by T1-weighted sequences on the sagittal and the axial planes. T2-weighted pulse sequences on the coronal plane were useful for the anatomical definition of the brachial plexus and for eventual tissue characterization. The correct representation of the anatomical structures of the brachial plexus allowed by MR imaging with our standard technique makes MR imaging the most appropriate exam for the diagnosis of pathologic conditions in the brachial plexus, although its use must be suggested by specific clinical questions.

Adult↗
PubMedDate not supplied

[Radiological examination of the thorax in intensive therapy centers].

Bedside chest radiography plays a considerable role in the whole of the exams carried out in hospitals, especially in intensive care units. Many clinical problems (pulmonary, cardiac, and mediastinal) are related to this examination and can be dealt with only when the radiologist is provided with high-quality radiographs. Therefore, it is extremely important for the radiologist himself to be aware of the various factors implied in the making and reproducing of bedside chest radiographs, which is a fundamental step in the monitoring of the patients undergoing intensive care. These factors can be divided into methodological factors (patient positioning, focus-film distance, and exposure) and technical factors (portable units, survey system). In this paper, a special emphasis is put on a survey system consisting in double differentiated screens and double film, which allows the acquisition of a normo-exposed radiograph of the parenchyma and of one of the mediastinum with a single exposure. Besides these technical and methodological elements, the radiologist must pay attention to the diagnostic-therapeutical means (such as tubes, small probes, and catheters) used on most patients in intensive care units. Their exact positioning must always be checked, and possible incorrect positioning and complications must be detected promptly. All these factors, as well as their scrupulous and constant application, contribute to markedly improve the dialogue between clinician and radiologist, by allowing a rapid evaluation of the cause of the clinical case under examination and its adequate treatment.

Humans↗
PubMedDate not supplied

[Thoracic radiography. Comparison of asymmetric screen-film, technic of mechanical homogenization, and conventional technics].

This study was aimed at comparing three different systems, i.e., asymmetric screen-film, mechanical homogenized and conventional techniques, in standing frontal and lateral plain radiographs of the chest. Two hundred consecutive patients with normal posteroanterior (PA) and lateral films were randomly subdivided into 4 groups. Each group was submitted to chest radiographs with a different technique: asymmetric screen-film systems (InSight HC and High Light GCA), mechanical homogenized (Tau-Gil Homogenized) and conventional high-kilovoltage techniques. The exposure values for frontal projections ranged 110 kV (InSight HC) to 141 kV (Tau-Gil), while for lateral projections they ranged 123 kV (conventional technique) to 143 kV (Tau-Gil). Statistically significant differences were observed between the two asymmetric systems as regards exposure values, High Light exhibiting higher mean values in the frontal projection (t-test p < 0.05). Image quality was studied jointly by 3 experienced chest radiologists. The observers were asked to grade, on a 3-point ordinal scale, the conspicuity of mediastinal borders, of pulmonary vessels and of selected areas of lung parenchyma (i.e., retrocardiac, retrosternal and apical regions), as well as overall image quality on the frontal projection. The statistical analysis of paired differences was performed with the Mann-Whitney U-test. The asymmetric and the mechanical homogenized techniques were much better than the conventional technique in depicting tracheobronchial tree, retrocardiac parenchyma, azygos-esophageal recess and thoracic spine (p < 0.05). The mechanical homogenized system provided best overall image quality on frontal films, being superior to both InSight HC and conventional techniques, but not to the High Light GCA system; only the frontal projection obtained with the homogenized technique was compared, no filter being available for the lateral projection. When the two asymmetric systems were compared, the High Light system better depicted vascular structures on frontal films (p < 0.05), while apical areas were better demonstrated with the InSight system, namely with lateral films (p < 0.05).

Female↗
PubMedDate not supplied

[Staging of pulmonary apex tumors. Computerized tomography versus magnetic resonance].

Apical lung cancers account for about 5% of pulmonary lesions and can be divided into two groups: Pancoast and non-Pancoast lesions. Recently, the use of MRI has been suggested in combination with CT to stage this kind of lung cancer. In this paper the authors' experience is reported relative to the current role of MRI and CT in the staging of apical lung cancers. Twelve male patients (mean age: 60.5 years) with apical lung cancers underwent conventional X-ray, CT and MR examinations of the chest. CT and MR images were studied by two independent radiologists with specific experience; surgery was the gold standard in three patients and MR and clinical symptoms in the patients not referred for surgery. In 15/108 cases (13.8%) CT and MR findings were in disagreement but in 93/108 cases (86.2%) they were in agreement. The highest disagreement rate was observed in the study of apical chest wall infiltration (33.3%), while in the study of anonymous vein involvement CT and MRI were always in agreement. The correct assessment of the regional extent of apical lung cancers is mandatory for treatment planning. In this kind of tumors MRI can be considered the method of choice thanks to its high contrast resolution and multiplanar imaging capabilities.

Adult↗
PubMedDate not supplied

[Bedside thoracic radiography: a comparison between 3 different types of grid].

Bedside chest radiography accounts for an increasingly large portion of all chest X-ray examinations. Nevertheless, image quality is often poor mainly because of scattered radiations which decrease image contrast. Moreover, usually no grid is employed because of difficult beam alignment. This work was aimed at comparing different radiologic grids for bedside chest radiography. Fifty patients submitted to two bedside chest radiographs in 24 hours were studied. All the patients underwent the first exam with a Kodak InSight cassette with a newly-designed (columnar type) grid inside, while the second exam was performed with a conventional 8:1 focused lead-strip grid (Gilardoni) in 25 patients and with a 6:1 focused lead-strip grid (Gilardoni) in the extant 25 patients. Both grids were assembled in a Kodak InSight radiographic cassette. Three independent radiologists evaluated film quality, focusing on the depiction of some anatomical structures--e.g., the tracheobronchial tree, the retrocardiac lung, and devices. Seventy-five examinations were obtained for each grid and for each evaluated structure and graded as "good", "acceptable" and "poor". In the 6:1 vs columnar grid test, the highest rate of "good" and "acceptable"--i.e., diagnostic--findings was observed with the columnar grid in evaluating pulmonary vessels (71/75); the highest rate of "poor" findings was obtained with the same grid in evaluating tracheal bifurcation (43/75). In the 8:1 vs columnar grid test, the highest rate of diagnostic findings was shown by the conventional grid in evaluating retrocardiac lung parenchyma and by the columnar grid for pulmonary vessels (69/75); the highest rate of "poor" findings was obtained with the columnar grid in evaluating tracheal bifurcation (40/75). The statistical analysis of the results (Wilcoxon test) was made to compare the two conventional grids with the new columnar one. Statistically significant differences were observed between the 8:1 grid and the columnar grid to evaluate the bronchial tree. No differences were observed between the 8:1 grid and the columnar grid. Furthermore, to determine the effects of different degrees of grid decentering on image quality, a series of exposures was made using a lung-chest phantom. The grids, both the lead-stripe and the columnar one, were comparable. The higher-ratio grid proved better in evaluating tiny details. The columnar grid exhibited better tolerance to X-ray beam and to grid decentering.

Equipment Design↗
PubMedDate not supplied

Pulmonary embolism: the role of computed tomography and magnetic resonance imaging.

The technological progress in Computed Tomography (CT) (spiral and electron beam) and Magnetic Resonance Imaging (MRI fast sequences) has stimulated their interest in the diagnosis of acute and chronic pulmonary embolism (PE). They are noninvasive procedures able to identify thrombi up to the level of segmental pulmonary branches. This result, albeit not ideal, is significant, in view of the lower clinical relevance of peripheral emboli as compared to more central locations, especially in the absence of peripheral venous thrombosis. Spiral CT allows satisfactory assessment of pulmonary branches with high sensitivity (65-100%), specificity (89-96%), positive predictive value (95%) and negative predictive value (80-100%) in the diagnosis of PE. MRI with spin-echo sequences has also a satisfactory sensitivity (75-90%), specificity (up to 100%), positive predictive value (86%) and negative predictive value (85%). Recently, MR angiography was shown to be able to depict smaller pulmonary branches (6th and 7th generation), even if its efficacy in the identification of emboli has not been demonstrated as yet. CT and MRI are bound to play an increasingly relevant role in the diagnosis of PE.

Humans↗